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Organization

MA PLASTIC SURGERY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAREEF JANDALI MD (MD)
(413) 200-9906
Entity
Organization

Contact information

Practice address
200 N MAIN ST SOUTH BLDG SUITE3, UNIT 9, EAST LONGMEADOW, MA 01028-2392
(413) 200-9906
Mailing address
21 SOUTHPORT TER, SOUTHPORT, CT 06890-1492
(203) 604-5865

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
09/07/2022
Last updated
09/07/2022
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