Provider Demographics
NPI:1730233594
Name:PLASTIC SURGERY ASSOCIATES OF NEW CITY, P.C.
Entity type:Organization
Organization Name:PLASTIC SURGERY ASSOCIATES OF NEW CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-634-4554
Mailing Address - Street 1:125 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3501
Mailing Address - Country:US
Mailing Address - Phone:845-634-4554
Mailing Address - Fax:845-639-1959
Practice Address - Street 1:125 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3501
Practice Address - Country:US
Practice Address - Phone:845-634-4554
Practice Address - Fax:845-639-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ089131Medicare ID - Type Unspecified
NYWET321Medicare ID - Type Unspecified