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Contact Information

PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC
204 WORCESTER ST
WELLESLEY, MA02481-5420
 Phone: 781-489-6218
 Fax: 781-489-6751
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Surgery of the Hand

2086S0105X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC

NPI # 1023105947
LBN Legal business name PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC
Authorized official KENNETH MARSHALL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2006
Last updated 01/22/2013 - About 13 years ago
Identifiers
MA Other M12935 BCBS GROUP NUMBER
MA Other 600215 TUFTS HEALTH PLAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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