Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Advanced Plastic Surgery of Northshore, PC

Organization Specialist · NPI 1114114105

Advanced Plastic Surgery of Northshore, PC is a Specialist in Lake Success, New York. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2500 Marcus Ave Ste 103
Lake Success, NY 11042-1018
Phone: (516) 354-1330
Fax: (516) 775-5953
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1114114105
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mahira Tanovic — Plastic And Hand Surgeon · (516) 354-1330
NPI enumeratedOctober 3, 2007
Last updated in NPPESSeptember 19, 2022
Certification dateSeptember 19, 2022
Mailing address2500 Marcus Avenue, Suite, 103, Lake Success, NY 11042-1018

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