Enisman Freedman Sepulveda Plastic Surgeons PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

172205-1 Issued in NY

Legal business name

ENISMAN FREEDMAN SEPULVEDA PLASTIC SURGEONS PC

Practice address

207 Washington St
Suite 203a
Poughkeepsie, NY 12601-1356

Phone

(845) 471-0800

Fax

(845) 471-0863

NPI assigned

Apr 7, 2010

Last updated

Apr 7, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Celestino Eddie Sepulveda Jr., M.D.

Title

President

Phone

(914) 204-7056

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1407171093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 WASHINGTON ST",
            "address_2": "SUITE 203A",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011356",
            "telephone_number": "845-471-0800",
            "fax_number": "845-471-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 WASHINGTON ST",
            "address_2": "SUITE 203A",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011356",
            "telephone_number": "845-471-0800",
            "fax_number": "845-471-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENISMAN FREEDMAN SEPULVEDA PLASTIC SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "CELESTINO",
        "authorized_official_middle_name": "EDDIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-204-7056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "172205-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.