Northeast Breast Reconstruction LLC
NPI #1255879748 in Southport, Connecticut
Provider Information
- NPI Number
- 1255879748
- Entity Type
- Organization
- Organization Name
- Northeast Breast Reconstruction LLC
- Primary Specialty
- Surgery - Plastic and Reconstructive Surgery
- Enumeration Date
- Feb 6, 2017
- Last Updated
- Feb 6, 2017
Practice Location
- Address
- 21 SOUTHPORT TERRACE
- City
- Southport
- State
- Connecticut
- ZIP Code
- 06890
- Phone
- (718) 672-2824
Authorized Official
- Name
- DR. SHAREEF JANDALI, M.D.
- Title
- OWNER
- Phone
- (718) 672-2824
Specialties & Taxonomy Codes
| Specialty |
|---|
| Surgery - Plastic and Reconstructive Surgery — Plastic and Reconstructive Surgery |
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