# KOR EAST 72ND STREET MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Manhattan Aesthetic Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346427184
- **Authorized official:** MISS KENNETH OWNE ROTHAUS MD (CHIEF MEDICAL OFFICE)
- **Authorized official phone:** (212) 737-0770

## Contact information

- **Practice address:** 325 EAST 72ND STREET, NEW YORK, NY 10021
- **Practice address phone:** (212) 772-7229
- **Practice address fax:** (212) 737-0103
- **Mailing address:** 325 EAST 72ND STREET, NEW YORK, NY 10021
- **Mailing address phone:** (212) 772-7229
- **Mailing address fax:** (212) 737-0103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 01/23/2008