Nordberg Plastic Surgery Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NORDBERG PLASTIC SURGERY CENTER, LLC

Doing business as

Imagine Aesthetics

Practice address

2001 W Main St
Suite 150
Stamford, CT 06902

Phone

(203) 324-4700

Fax

(203) 324-5691

NPI assigned

May 7, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Leif O Nordberg, MD

Title

President

Phone

(203) 324-4700

Specialties & licenses 1

Addresses

Other names 1

• Imagine Aesthetics Doing business as

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1801231659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W MAIN ST",
            "address_2": "SUITE 150",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024501",
            "telephone_number": "203-324-4700",
            "fax_number": "203-324-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W MAIN ST",
            "address_2": "SUITE 150",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06902",
            "telephone_number": "203-324-4700",
            "fax_number": "203-324-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORDBERG PLASTIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-07",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "NORDBERG",
        "authorized_official_first_name": "LEIF",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-324-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Imagine Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen J. Nishida, MD
• Dana Marie Nixon, CCC-SLP
• Katherine Kelly Noble, M.D.
• Katarzyna Noonan, APRN
• Mohammed Abdulkadir Nor
• Norma Medical Massage
• Enid S. Norris, MS, LMFT
• North Stamford Medical Associate
• Lucas Northern, SLP
• Norwalk Gynecology Center LLC

• Clinic/Center in Stamford, CT
• Providers in Stamford, CT by specialty
• Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.