Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center | |
Research |
261QR1100X |
| NPI # | 1619172970 |
| LBN Legal business name | AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC |
| Authorized official | JOHN DECORATO - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/18/2007 |
| Last updated | 09/11/2025 - About 9 months ago |
| Identifiers | n/a |
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