Provider Demographics
NPI:1053740241
Name:AESTHETIC PLASTIC SURGERY OF NORTH SHORE PC
Entity type:Organization
Organization Name:AESTHETIC PLASTIC SURGERY OF NORTH SHORE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ANOUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:HADAEGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-222-2292
Mailing Address - Street 1:900 CUMMINGS CTR STE 301U
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 CUMMINGS CTR STE 301U
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6181
Practice Address - Country:US
Practice Address - Phone:413-222-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81524261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty