# MONA LISA COSMETIC SURGERY CENTER

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

## Provider details

- **NPI number:** 1770801086
- **Authorized official:** RAMTIN KASSIR M.D., F.A.C.S. (PHYSICIAN)
- **Authorized official phone:** (973) 692-9300

## Contact information

- **Practice address:** 1176 HAMBURG TPKE, WAYNE, NJ 07470-5069
- **Practice address phone:** (973) 692-9300
- **Practice address fax:** (973) 692-9301
- **Mailing address:** 1176 HAMBURG TPKE, WAYNE, NJ 07470-5069
- **Mailing address phone:** (973) 692-9300
- **Mailing address fax:** (973) 692-9301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NJ | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | MA065731 | NJ | Yes |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | MA065731 | NJ | — |

## Other

- **Enumeration date:** 05/11/2010
- **Last updated:** 05/11/2010