NORTHEAST BREAST RECONSTRUCTION LLC – NPI #1255879748
Surgery

A surgeon who specializes in plastic and reconstructive surgery.

NORTHEAST BREAST RECONSTRUCTION LLC is a surgeon located in SOUTHPORT, CT. NPPES has assigned the NPI number 1255879748 to NORTHEAST BREAST RECONSTRUCTION LLC on February 06, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2086S0122X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Plastic and Reconstructive Surgery

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHEAST BREAST RECONSTRUCTION LLC below.

NPI Profile for
NORTHEAST BREAST RECONSTRUCTION LLC

NPI Number
1255879748
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHEAST BREAST RECONSTRUCTION LLC
Primary location
21 SOUTHPORT TERRACE
SOUTHPORT, CT 06890
Phone: (718) 672-2824 Fax: (718) 672-3280
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHAREEF JANDALI
OWNER
Phone: (718) 672-2824
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0122X
- Surgery / Plastic and Reconstructive Surgery (Primary)
NJ 25MA10021400

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.