Organization
PLASTIC AND RECONSTRUCTIVE SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA ELDRIDGE BORN RN (PRACTICE MANAGER SEC TREA OF CORP)
(717) 741-9599
Entity
Organization
Contact information
Practice address
2295 S GEORGE ST, YORK, PA 17403
(717) 741-9599
(717) 741-0420
Mailing address
2295 S GEORGE ST, YORK, PA 17403
(717) 741-9599
(717) 741-0420
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001164812004
—
PA
01
—
01873201
CAPITAL BLUE CROSS
—
01
—
1523691
GATEWAY
PA
01
—
20009842
AMERIHEALTH MERCY
PA
01
—
240006830
RAILROAD MEDICARE
PA
01
—
742753
BLUE SHIELD
PA
01
—
P018712A002
CHAMPUS
—
Enumeration date
03/10/2006
Last updated
11/24/2010
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