De Omilia Plastic Surgery PC
Oral & Maxillofacial Surgery in Basking Ridge, New Jersey
1164618435- Practice location
- 96 South Finley Ave, Basking Ridge, NJ 07920
- Phone
- 908-221-1136
- Fax
- 908-221-0482
- Last updated
- April 3, 2008
De Omilia Plastic Surgery PC is a healthcare organization based in Basking Ridge, NJ. De Omilia Plastic Surgery PC practices in Basking Ridge, NJ. The NPI Number for De Omilia Plastic Surgery PC is 1164618435 and holds a License No. 25MA07315300 (NJ). The current practice location address for De Omilia Plastic Surgery PC is 96 South Finley Ave, Basking Ridge, NJ 07920 and can be reached out via phone at 908-221-1136 and via fax at 908-221-0482.
Provider Profile Details
- NPI Number
- 1164618435
- Provider Name
- De Omilia Plastic Surgery PC
- Provider Entity Type
- Organization
- Address
- 96 South Finley Ave, Basking Ridge, NJ 07920
- Phone Number
- 908-221-1136
- Fax Number
- 908-221-0482
- Primary Taxonomy
- Oral & Maxillofacial Surgery · 204E00000X
- Organization Subpart
- No
- Authorized Official
- Dr. David Z Evdokimow, MD · Owner · 908-221-1136
- Provider Enumeration Date
- September 20, 2007
- Last Update Date
- April 3, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 96 South Finley Ave
Basking Ridge, NJ 07920 - City
- Basking Ridge
- State
- New Jersey
- Zip
- 07920
- Phone Number
- 908-221-1136
- Fax Number
- 908-221-0482
Provider Business Mailing Address Details
- Address
- 96 South Finley Ave
Basking Ridge, NJ 07920 - City
- Basking Ridge
- State
- NJ
- Zip
- 07920
- Phone Number
- 908-221-1136
- Fax Number
- 908-221-0482
License Information
- License Number (1)
- 25MA07315300
- License State (1)
- NJ
- Taxonomy (1)
- Plastic Surgery · 208200000X
- License Number (2)
- 25MA07315300
- License State (2)
- NJ
- Taxonomy (2)
- Plastic Surgery, Surgery of the Hand · 2082S0105X
- License Number (3)
- 25MA07315300
- License State (3)
- NJ
- Taxonomy (3)
- Oral & Maxillofacial Surgery · 204E00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Oral & Maxillofacial Surgery providers near Basking Ridge, NJ
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- Liberty Corner Surgical Center LLCClinic/Center, Ambulatory Surgical · NPI 1487117370
- Julie A PfefferGenetic Counselor, MS · NPI 1316845019
- Emily AckerNurse Practitioner, Family · NPI 1578461059
- Eric WardRegistered Nurse · NPI 1104723873
Frequently Asked Questions
What is the NPI number of De Omilia Plastic Surgery PC?
The NPI number of De Omilia Plastic Surgery PC is 1164618435. It was assigned on September 20, 2007 and is currently active in the NPPES registry.
What is the specialty of De Omilia Plastic Surgery PC?
De Omilia Plastic Surgery PC is registered under the primary taxonomy Oral & Maxillofacial Surgery (code 204E00000X), licensed in NJ under license number 25MA07315300.
Where does De Omilia Plastic Surgery PC practice?
The practice location is 96 South Finley Ave, Basking Ridge, NJ 07920. The office can be reached at 908-221-1136 (phone) or 908-221-0482 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1164618435 directly on the NPPES registry website.