Provider Demographics
NPI:1871747998
Name:NASSAU PLASTIC SURGICAL ASSOCIATES PC
Entity type:Organization
Organization Name:NASSAU PLASTIC SURGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-484-0800
Mailing Address - Street 1:1 EXPRESSWAY PLZ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2047
Mailing Address - Country:US
Mailing Address - Phone:516-484-0800
Mailing Address - Fax:516-484-0833
Practice Address - Street 1:1 EXPRESSWAY PLZ
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2047
Practice Address - Country:US
Practice Address - Phone:516-484-0800
Practice Address - Fax:516-484-0833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127339208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC09920Medicare UPIN