Organization
INTERNATIONAL COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARROLL LESESNE (PRESIDENT)
(212) 570-6318
Entity
Organization
Contact information
Practice address
2 MERCIA LN, GREENWICH, CT 06830-7068
(212) 570-6318
Mailing address
2 MERCIA LN, GREENWICH, CT 06830-7068
(212) 570-6318
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2008
Last updated
10/20/2010
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