NPI 1073755443

Elevation Plastic Surgery, PC

Organisation Plastic Surgery Physician New Haven, CT

Practice location

Address: 60 Temple St Suite 4b, New Haven, CT 06510-2716
Phone: (203) 752-0015
Fax: (203) 772-2814

Authorised official

Name: Leo Ryo Otake
Title: Medical Director
Phone: (203) 752-0015

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 046053 (CT)

Other Plastic Surgery providers in Connecticut →

Registry record

NPI: 1073755443
Entity type: Organization
NPI issued: 1 Apr 2009
Record last updated: 1 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.