Main Line Plastic Surgery&Laser Associates

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

15511501 Issued in PA

Legal business name

MAIN LINE PLASTIC SURGERY&LASER ASSOCIATES

Practice address

216 Mall Blvd
Suite 101
King of Prussia, PA 19406-2923

Phone

(610) 354-8800

Fax

(610) 354-9066

NPI assigned

Dec 10, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard P. Glunk, M.D.

Title

President

Phone

(610) 354-8800

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1356586028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MALL BLVD",
            "address_2": "SUITE 101",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062923",
            "telephone_number": "610-354-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MALL BLVD",
            "address_2": "SUITE 101",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062923",
            "telephone_number": "610-354-8800",
            "fax_number": "610-354-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE PLASTIC SURGERY&LASER ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "GLUNK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-354-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "15511501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Magor
• Kathleen Magurn
• Mary Ellen Mahoney, DPT
• Kathleen Ann Mahony, BSN, RN FIRST ASSIST
• Allison Maier
• Main Line Spine Surgery Center, LLC
• Main Line Vascular Institute LLC
• Main Line Wellness LLC
• Bethany Maldonado
• Allison Maleski

• Ambulatory Surgical Clinic/Center in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.