Provider Demographics
NPI:1174785711
Name:CROSS PLASTIC SURGERY ASSOCIATES PLLC
Entity type:Organization
Organization Name:CROSS PLASTIC SURGERY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-419-4051
Mailing Address - Street 1:420 W LINFIELD TRAPPE RD
Mailing Address - Street 2:STE 3300
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-4278
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 W LINFIELD TRAPPE RD
Practice Address - Street 2:STE 3300
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4278
Practice Address - Country:US
Practice Address - Phone:866-419-4051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty