Organization Active NPI

Manhattan Facial Plastic Surgery and Ear Nose & Throat Professional

  • Otolaryngology/Facial Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1609484492
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
Legal business name
MANHATTAN FACIAL PLASTIC SURGERY AND EAR NOSE & THROAT PROFESSIONAL
Practice address
400 East 20TH Street Ste 3F
New York, NY 10009
Phone
(212) 381-6110
Fax
(212) 381-6110
NPI assigned
Jul 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Authorized official

Name
Diane Williams
Title
Credentialing Consultant
Phone
(570) 801-1847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0905X Primary

Addresses

Primary practice location

400 East 20TH Street Ste 3F
New York, NY 10009

Mailing address

400 E 20TH St Apt 3F
New York, NY 10009-8105
Phone (212) 381-6110

National Provider Directory

National Provider Directory

Locations

335 E 14th St
Unit 412
New York, NY 10009

247 3rd Ave
Rm 404
New York, NY 10010
Phone (212) 381-6110

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1609484492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 20TH ST APT 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100098105",
            "telephone_number": "212-381-6110",
            "fax_number": "212-381-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST 20TH STREET STE 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10009",
            "telephone_number": "212-381-6110",
            "fax_number": "212-381-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN FACIAL PLASTIC SURGERY AND EAR NOSE & THROAT PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-17",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CREDENTIALING CONSULTANT",
        "authorized_official_telephone_number": "570-801-1847"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.