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

Renaissance Plastic Surgery PLLC

Organization Plastic and Reconstructive Surgery Physician · NPI 1639880677

Renaissance Plastic Surgery PLLC is a Plastic and Reconstructive Surgery Physician in New York, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

590 5th Ave Fl 11
New York, NY 10036-4748
Phone: (917) 387-7834
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X

Record details

NPI number1639880677
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Irina Domantovsky — President · (917) 387-7834
NPI enumeratedDecember 12, 2022
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024
Mailing addressPo Box 220424, Great Neck, NY 11022-0424

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