National Provider Identifier Database

PHOENIX OCULOPLASTIC CONSULTANTS PLLC
Plastic Surgery Within the Head and Neck

A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.


Contact Information

PHOENIX OCULOPLASTIC CONSULTANTS, PLLC
3410 N 4TH AVE
PHOENIX, AZ85013-3905
Phone: 602-257-1499
Fax: 480-361-3517
Website:
Specialty Taxonomy Code
* Plastic Surgery Within the Head and Neck 2082S0099X
Ophthalmology 207W00000X

* Indicates primary specialty

NPI Profile & details for PHOENIX OCULOPLASTIC CONSULTANTS, PLLC

NPI Number 1497009641
Legal business name
LBN
PHOENIX OCULOPLASTIC CONSULTANTS, PLLC
Authorized official MISHA FAUSTINA - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 11/08/2012
Last updated 11/08/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: 33016
  • AZ Medicaid: 608730
  • AZ Medicaid: 868672
  • Other: 1669438057 NPI
  • Other: 1952570194 NPI

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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