Organization
GLOW MEDISPA
Active
Other names
GLOW AESTHETICA AND SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
SOOFIA RUBBANI M.D. (PRESIDENT)
(516) 801-1106
Entity
Organization
Contact information
Practice address
1 EXPRESSWAY PLZ, SUITE 115, ROSLYN HEIGHTS, NY 11577-2047
(516) 801-1106
(516) 801-1312
Mailing address
1 EXPRESSWAY PLZ, SUITE 115, ROSLYN HEIGHTS, NY 11577-2047
(516) 801-1106
(516) 801-1312
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
237435
NY
Other
Enumeration date
10/28/2008
Last updated
10/13/2009
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