Organization
SRB PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STAFFORD R BROUMAND M.D. (PRESIDENT)
(212) 879-7900
Entity
Organization
Contact information
Practice address
740 PARK AVE, NEW YORK, NY 10021-4251
(212) 879-7900
Mailing address
SRB PLASTIC SURGERY PC, 75 E 71ST STREET, NEW YORK, NY 10021-4251
(212) 879-7900
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
166718
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100923
GHI
NY
01
—
80H671
BLUE CROSS BLUE SHIELD
NY
01
—
N37868
HEALTH NET
NY
01
—
P3806444
OXFORD
NY
Enumeration date
05/23/2007
Last updated
06/16/2018
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