Ma Plastic Surgery PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

MA PLASTIC SURGERY PLLC

Practice address

200 N Main St South BLDG Suite3, Unit 9
East Longmeadow, MA 01028-2392

Phone

(413) 200-9906

NPI assigned

Sep 7, 2022

Last updated

Sep 7, 2022By 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

Shareef Jandali, MD

Title

MD

Phone

(413) 200-9906

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1689395725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SOUTHPORT TER",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901492",
            "telephone_number": "203-604-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MAIN ST SOUTH BLDG SUITE3, UNIT 9",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010282392",
            "telephone_number": "413-200-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MA PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "JANDALI",
        "authorized_official_first_name": "SHAREEF",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "413-200-9906",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andea Christina Lopez, LMT
• Jacqueline A Lopez
• Ezequiel Lugo
• Mary Lou Lusa, M.S., LMHC
• Joseph Charles Lyons
• Deaven Nicole Macias, DO
• Kim McGillicuddy Maciaszek, OD
• Marianne Maher, RD LDN
• John Michael Makowicz
• Thenu Manikantan, M.D.

• Plastic Surgery Physician in East Longmeadow, MA
• Providers in East Longmeadow, MA by specialty
• Plastic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.