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Organization

NORTHEAST PLASTIC SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VINOD PATHY M.D. (OWNER)
(917) 699-3727
Entity
Organization

Contact information

Practice address
5-1 DAVIS ROAD WEST, SUITE 3, OLD LYME, CT 06371
(917) 699-3727
(718) 672-4251
Mailing address
12 HALLS RD, UNIT 878, OLD LYME, CT 06371-7000
(917) 699-3727
(718) 672-4251

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
045607
CT

Other

Enumeration date
05/01/2015
Last updated
05/01/2015
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