Organization
COSMETIC SURGERY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN B BRACKUP MD (MEDICAL DIRECTOR)
(215) 750-9400
Entity
Organization
Contact information
Practice address
1717 LANGHORNE NEWTOWN RD STE 150, LANGHORNE, PA 19047-1089
(215) 750-9400
(215) 750-7400
Mailing address
1717 LANGHORNE NEWTOWN RD STE 150, LANGHORNE, PA 19047-1089
(215) 750-9400
(215) 750-7400
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
PA
261QA0005X
Ambulatory Family Planning Facility
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177533000
KEYSTONE
PA
01
—
2240312
AETNA HMO
PA
01
—
409559
PERSONAL CHOICE
PA
01
—
5114215
AETNA PPO
PA
Enumeration date
01/03/2007
Last updated
07/21/2022
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