Provider Demographics
NPI:1730330903
Name:THE CENTER FOR COSMETIC SURGERY, PC
Entity type:Organization
Organization Name:THE CENTER FOR COSMETIC SURGERY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KYM
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-429-1151
Mailing Address - Street 1:1050 BEECHER XING N
Mailing Address - Street 2:SUITE C
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4567
Mailing Address - Country:US
Mailing Address - Phone:800-429-1151
Mailing Address - Fax:412-429-0211
Practice Address - Street 1:2275 SWALLOW HILL RD
Practice Address - Street 2:SUITE 2400
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1656
Practice Address - Country:US
Practice Address - Phone:412-429-1151
Practice Address - Fax:412-429-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical