Organization
RENAISSANCE PLASTIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA DOMANTOVSKY MD (PRESIDENT)
(917) 387-7834
Entity
Organization
Contact information
Practice address
590 5TH AVE FL 11, NEW YORK, NY 10036-4748
(917) 387-7834
Mailing address
PO BOX 220424, GREAT NECK, NY 11022-0424
(917) 387-7834
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
12/12/2022
Last updated
07/09/2024
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