NPIMap

Organization Active NPI

Stanislaw Facial Plastic Surgery Center, LLC

  • Plastic Surgery Physician
  • Avon, CT
National Provider Identifier
1700878576
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
STANISLAW FACIAL PLASTIC SURGERY CENTER, LLC
Practice address
35 Nod Rd
Suite 204
Avon, CT 06001-3826
Phone
(860) 409-1515
NPI assigned
Aug 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Authorized official

Name
Dr. Paul Stanislaw Jr., MDNPI 1457343220
Title
Owner
Phone
(860) 409-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

35 Nod Rd
Suite 204
Avon, CT 06001-3826

Mailing address

35 Nod Rd
Suite 204
Avon, CT 06001-3826
Phone (860) 409-1515

Other names 1

  • FACIAL PLASTIC SURGERY CENTER OF NEW ENGLAND, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

35 Nod Rd
Ste 204
Avon, CT 06001
Phone (860) 409-1515

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1700878576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 NOD RD",
            "address_2": "SUITE 204",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013826",
            "telephone_number": "860-409-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 NOD RD",
            "address_2": "SUITE 204",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013826",
            "telephone_number": "860-409-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANISLAW FACIAL PLASTIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "STANISLAW",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-409-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "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": [
        {
            "organization_name": "FACIAL PLASTIC SURGERY CENTER OF NEW ENGLAND, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.