MONA LISA COSMETIC SURGERY CENTER (NPI# 1770801086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770801086 |
| Entity Type | Organization |
| Organization Name | MONA LISA COSMETIC SURGERY CENTER |
| Practice Address |
1176 Hamburg Tpke Wayne NJ 07470-5069 |
| Practice Telephone | 9736929300 |
| Practice Fax Number | 9736929301 |
| Mailing Telephone | 9736929300 |
| Mailing Fax Number | 9736929301 |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |
| Authorized Official Name | RAMTIN KASSIR (PHYSICIAN) |
| Authorized Official Telephone | 9736929300 |
| Authorized Official Credential | M.D., F.A.C.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | NJ | Allopathic & Osteopathic Physicians | |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
MA065731 | NJ | Allopathic & Osteopathic Physicians |
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
MA065731 | NJ | Allopathic & Osteopathic Physicians |
| Street Address |
1176 HAMBURG TPKE |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-5069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063415990 | Advanced Ambulatory Anesthesia, LLC | Specialist | 1176 Hamburg Tpke, Wayne, NJ 07470-5054 | 2005-05-24 |
| 1184749673 | Wayne Surgical Center LLC | Clinic/Center | 1176 Hamburg Tpke, Wayne, NJ 07470-5069 | 2007-03-21 |
| 1477591048 | Ramtin Kassir | Otolaryngology | 1176 Hamburg Tpke, Wayne, NJ 07470-5069 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073086 | Brightview Hamburg, LLC | Alzheimer Center (Dementia Center) | 1139 Hamburg Turnpike, Wayne, NJ 07470 | 2020-11-03 |
| 1912536301 | Stevenson Dominique | Physician Assistant | 1700 Nj-23 # 170, Wayne, NJ 07470 | 2020-04-07 |
| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538230313 | Pinnacle Ent Alliance LLC | Otolaryngology | 994 Old Eagle School Rd, Suite 1017, Wayne, PA 19087-1802 | 2006-11-13 |
| 1801842893 | Gangadhar S Sreepada | Otolaryngology | 1211 Hamburg Tpke, Suite 205, Wayne, NJ 07470 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922416387 | Jan Czerepak | Otolaryngology | 325 Molnar Dr, Elmwood Park, NJ 07407-3207 | 2014-07-30 |
| 1386968220 | Lawrence Gordon Md Pllc | Otolaryngology | 521 Route 515, Vernon, NJ 07462-3033 | 2010-03-22 |
| 1093953762 | Alan M. Tell, Md | Otolaryngology | 140 Prospect Ave., Suite 7, Hackensack, NJ 07601-2260 | 2009-02-03 |
| 1093872640 | Frank S Dimauro | Otolaryngology | 106 E Jimmie Leeds Rd, Galloway, NJ 08205-9508 | 2007-01-02 |
| 1770507337 | Scott L Busch | Otolaryngology | 1797 Springdale Rd, Cherry Hill, NJ 08003-2136 | 2006-07-27 |
| 1013940717 | Scott Richard Schaffer | Otolaryngology | 406 Lippincott Dr Ste F, Marlton, NJ 08053-4168 | 2006-07-08 |
| 1376586412 | David Bromberg | Otolaryngology | 292 Hurffville Grenloch Rd, Suite 100, Sewell, NJ 08080-2656 | 2006-06-14 |
| 1871551812 | Francis Michael Jampol | Otolaryngology | 900 Lanidex Plz Ste 300, Parsippany, NJ 07054-2707 | 2006-05-01 |
| 1467428623 | Alvin Daniel Dubin | Otolaryngology | 1924 Route 70 E, Cherry Hill, NJ 08003-2118 | 2006-02-27 |
| 1568441988 | Amy D. Lazar | Otolaryngology | 245 Us Highway 22 Fl 3, Bridgewater, NJ 08807-2560 | 2006-01-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.