Organization
NORTHEAST PLASTIC SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAREEF JANDALI MD (OWNER)
(203) 604-5865
Entity
Organization
Contact information
Practice address
245 5TH AVE FL 3, NEW YORK, NY 10016-8728
(917) 708-0018
Mailing address
21 SOUTHPORT TER, SOUTHPORT, CT 06890-1492
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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