NORTHEAST PLASTIC SURGERY CENTER LLC (NPI# 1932586682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932586682 |
| Entity Type | Organization |
| Organization Name | NORTHEAST PLASTIC SURGERY CENTER LLC |
| Practice Address |
5-1 Davis Road West Suite 3 Old Lyme CT 06371 |
| Mailing Address |
12 Halls Rd Unit 878 Old Lyme CT 06371-7000 |
| Practice Telephone | 9176993727 |
| Practice Fax Number | 7186724251 |
| Mailing Telephone | 9176993727 |
| Mailing Fax Number | 7186724251 |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |
| Authorized Official Name | DR. VINOD PATHY (OWNER) |
| Authorized Official Telephone | 9176993727 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
045607 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
5-1 DAVIS ROAD WEST SUITE 3 |
| City | OLD LYME |
| State | CT |
| Zip Code | 06371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134761877 | Sabine Odonnell LLC | Marriage & Family Therapist | 80 Halls Rd, Old Lyme, CT 06371 | 2019-10-15 |
| 1619487162 | Emily Chung | Pharmacist | 42 Browns Ln, Old Lyme, CT 06371 | 2017-10-10 |
| 1659822088 | Mona Saleh Hassan | Nurse Practitioner | Medoptions, 55 Hatchetts Hill Road, Old Lyme, Ct, CT 06371 | 2016-10-20 |
| 1740653278 | New England Pa LLC | Physician Assistant | 5 Davis Road East, Old Lyme, CT 06371 | 2015-11-05 |
| 1285956987 | Karl R. Friedmann | Family Medicine | 40 Coult Lane, Old Lyme, CT 06371 | 2010-02-22 |
| 1285844977 | Cary L. Walker | Social Worker | 6 Town Street, Lyme, CT 06371 | 2007-05-23 |
| 1578784765 | Lynne Zimmerman | Psychologist | 16 Library Ln, Old Lyme, CT 06371 | 2007-05-02 |
| 1588784375 | Jan Fitzgerald Briscoe | Marriage & Family Therapist | 81 Halls Rd Unit C, Old Lyme, CT 06371 | 2007-03-29 |
| 1588702583 | Karl M Goldkamp | Naturopath | 81 Halls Road, Old Lyme, CT 06371 | 2007-02-02 |
| 1801801402 | The Finch Corp | Pharmacy | 90 Halls Rd, Old Lyme, CT 06371 | 2006-07-30 |
| Find all providers in zip 06371 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639556640 | New England Plastic Surgery Center | Surgery | 8 Vista Dr, Old Lyme, CT 06371-1587 | 2015-04-28 |
| 1700141330 | New England Plastic Surgery Group, LLC | Surgery | 8 Vista Dr, Old Lyme, CT 06371-1587 | 2012-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255879748 | Northeast Breast Reconstruction LLC | Surgery | 21 Southport Terrace, Southport, CT 06890 | 2017-02-06 |
| 1205168499 | Vinod V Pathy Md LLC | Surgery | 1525 Boston Post Rd, Westbrook, CT 06498-2044 | 2010-02-12 |
| 1568609121 | Stacey Lauren June | Surgery | 107 Newtown Road Suite 2c, Danbury, CT 06810 | 2009-01-19 |
| 1982861860 | Mark Manuel Melendez | Surgery | 4 Corporate Dr Ste 288, Shelton, CT 06484-6240 | 2008-05-19 |
| 1275602146 | Andrew Nelson Kornstein | Surgery | 539 Danbury Rd, Wilton, CT 06897-2216 | 2006-11-07 |
| 1831287275 | Sergio D. Francescon | Surgery | 540 S. Broad Street, Suite 3c, Meriden, CT 06450-6600 | 2006-10-11 |
| 1578583282 | Stephan Ariyan | Surgery | 60 Temple St Ste 7c, New Haven, CT 06510-2716 | 2006-07-19 |
| 1093795387 | Colleen J Jambor | Surgery | 33 Dale Road, Ste 1, Avon, CT 06001 | 2006-01-20 |
| 1053303818 | John F Reilly | Surgery | 2 Ivy Brook Rd, Suite 105, Shelton, CT 06484-6416 | 2005-08-18 |
| 1922515006 | The Plastic and Reconstructive Surgery Group, PC | Surgery | 2 Greenwich Office Park Ste 210, Greenwich, CT 06831-5155 | 2018-01-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.