Organization
AESTHETIQUE, COSMETIC AND LASER SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASAD S SUREDDI MD (OWNER)
(203) 264-6334
Entity
Organization
Contact information
Practice address
10 MAIN ST S, SOUTHBURY, CT 06488-2260
(203) 264-6334
(203) 267-7654
Mailing address
10 MAIN ST S, SOUTHBURY, CT 06488-2260
(203) 264-6334
(203) 267-7654
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
024062
CT
Other
Enumeration date
02/22/2013
Last updated
02/22/2013
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