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Organization
THEODOROU PLASTIC SURGERY, PC
Active
Organization
THEODOROU PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPERO JOHN THEODOROU MD (DIRECTOR)
(914) 237-6797
Entity
Organization
Contact information
Practice address
128 CENTRAL PARK S, NEW YORK, NY 10019-1565
(914) 237-6797
(914) 237-6790
Mailing address
976 MCLEAN AVE, SUITE 387, YONKERS, NY 10704-4105
(914) 237-6797
(914) 206-4950
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
228653-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228653-1
MEDICAL LICENSE
NY
Enumeration date
09/21/2006
Last updated
10/28/2014
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