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Organization
MANHATTAN RECONSTRUCTIVE SURGERY PC
Active
Organization
MANHATTAN RECONSTRUCTIVE SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRICK ANTELL MD (MEDICAL DIRECTOR)
(212) 988-4040
Entity
Organization
Contact information
Practice address
850 PARK AVE, NEW YORK, NY 10075-1845
(212) 988-4040
Mailing address
850 PARK AVE, NEW YORK, NY 10075-1845
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CERT# 1589
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CERT# 1589
AAAASF, INC.
NY
Enumeration date
05/03/2016
Last updated
05/03/2016
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