Pacifico Plastic Surgery Medical PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

261299 Issued in NY

Legal business name

PACIFICO PLASTIC SURGERY MEDICAL PLLC

Practice address

2372 Victory Blvd
Staten Island, NY 10314-6607

Phone

(718) 761-3700

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Denise Reich

Title

Manager

Phone

(718) 761-3700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Jude Lacqua, MD

  • Plastic Surgery Physician
  • Staten Island, NY
  • NPI 1992753883
  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1619488848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146607",
            "telephone_number": "718-761-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2372 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146607",
            "telephone_number": "718-761-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9602 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097851",
            "country_code": "US",
            "telephone_number": "718-761-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PACIFICO PLASTIC SURGERY MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "REICH",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-761-3700"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "261299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Orson Pachas, LMSW
• Ursula Pachas, RN
• Ruth Pacheco
• Tiffany Pacheco, PMHNP-BC
• Angela Paciello
• Inderbir Singh Padda, M.D.
• Coleen Paderon
• Jose Arnoldo Buendia Paderon, O.T.
• Carolina Christine Padilla
• Jocelyn Padilla, NP

• Plastic Surgery Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.