Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Cosmetic Surgery of New York PC

Organization Specialist · NPI 1124229562

Cosmetic Surgery of New York PC provides Specialist services in Port Jefferson Station, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
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

4616 Nesconset Hwy
Port Jefferson Station, NY 11776-2563
Phone: (631) 473-7070
Fax: (631) 331-2654
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X (NY)

Record details

NPI number1124229562
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Jacobs — Surgeon · (631) 473-7070
NPI enumeratedMay 31, 2007
Last updated in NPPESJuly 21, 2022
Mailing address4616 Nesconset Hwy, Port Jefferson Station, NY 11776-2563

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