Laser Breast Standard Cancer Surgery

NPI #1407101934 in Plainview, New York

Provider Information

NPI Number: 1407101934
Entity Type: Organization
Organization Name: Laser Breast Standard Cancer Surgery
Primary Specialty: Specialist
Enumeration Date: Jul 20, 2012
Last Updated: Jul 20, 2012

Practice Location

Address: 100 MANETTO HILL RD
Address 2: SUITE 210
City: Plainview
State: New York
ZIP Code: 11803
Phone: (516) 938-4686

Authorized Official

Name: VINCENT ANSANELLI JR.
Title: DIRECTOR
Phone: (516) 938-4686

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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