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Organization
AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC
Active
Organization
AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM DECORATO MD (PRESIDENT)
(718) 987-9165
Entity
Organization
Contact information
Practice address
2777 HYLAN BLVD, STATEN ISLAND, NY 10306-4660
(718) 987-9165
(718) 987-0305
Mailing address
2777 HYLAN BLVD, STATEN ISLAND, NY 10306-4660
(718) 987-9165
(718) 987-0305
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QR1100X
Research Clinic/Center
—
NULL
Other
Enumeration date
06/18/2007
Last updated
09/11/2025
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