National Provider Identifier Database

AESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC
Plastic and Reconstructive Surgery


Contact Information

AESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC
5700 W GENESEE ST
SUITE 132
CAMILLUS, NY13031-3200
Phone: 315-487-5858
Fax: 315-487-1950
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for AESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC

NPI Number 1609865054
Legal business name
LBN
AESTHETIC PLASTIC SURGERY OF SYRACUSE PLLC
Authorized official MARK POTENZA - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/18/2005
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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