# MANHATTAN FACIAL PLASTIC SURGERY AND EAR NOSE & THROAT PROFESSIONAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609484492
- **Authorized official:** DIANE WILLIAMS (CREDENTIALING CONSULTANT)
- **Authorized official phone:** (570) 801-1847

## Contact information

- **Practice address:** 400 EAST 20TH STREET STE 3F, NEW YORK, NY 10009
- **Practice address phone:** (212) 381-6110
- **Practice address fax:** (212) 381-6110
- **Mailing address:** 400 E 20TH ST APT 3F, NEW YORK, NY 10009-8105
- **Mailing address phone:** (212) 381-6110
- **Mailing address fax:** (212) 381-6110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/17/2020
- **Last updated:** 01/12/2021