Organization
VILLAGE PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEYMAN MAGHSOUDLOU (MANAGER)
(973) 773-2039
Entity
Organization
Contact information
Practice address
75 OAK ST, RIDGEWOOD, NJ 07450-2558
(973) 773-2039
Mailing address
PO BOX 623, CLIFTON, NJ 07012-0623
(973) 773-2039
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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