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 provides Specialist services 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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