Organization
PACIFICO PLASTIC SURGERY MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE REICH (MANAGER)
(718) 761-3700
Entity
Organization
Contact information
Practice address
2372 VICTORY BLVD, STATEN ISLAND, NY 10314-6607
(718) 761-3700
Mailing address
2372 VICTORY BLVD, STATEN ISLAND, NY 10314-6607
(718) 761-3700
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
261299
NY
Other
Enumeration date
10/16/2017
Last updated
03/17/2018
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