PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC
NPI 1023105947
Surgery - Plastic and Reconstructive Surgery in Wellesley, MA

Q: What is Plastic Reconstructive & Cosmetic Surgery PC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Active since October 10, 2006

204 WORCESTER ST, WELLESLEY, MA 02481(781) 489-6218(781) 489-6751 Get Directions Write a Review

NPPES record last updated: January 22, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Plastic Reconstructive & Cosmetic Surgery Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC (NPI 1023105947) is a healthcare organization registered as a plastic and reconstructive surgery in Wellesley, Massachusetts and active in the NPI registry since October 2006. The organization lists Kenneth A Marshall, President, as its authorized official.

NPPES Registry Identity

NPI1023105947

Entity TypeOrganization

Primary Taxonomy2086S0122X

Legal Business NamePLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC

Location Address204 WORCESTER STWellesley, MA 02481-5420

Mailing Address204 Worcester StWellesley, MA 02481-5420 · (781) 489-6218 · Fax (781) 489-6751

Phone(781) 489-6218

Fax(781) 489-6751

Organization SubpartNo

Authorized OfficialKenneth A MarshallPresident · (781) 489-6228

Enumeration DateOctober 10, 2006

Last NPPES UpdateJanuary 22, 2013

✔ NPI 1023105947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

Definition

A surgeon who specializes in plastic and reconstructive surgery.

Also ListedSurgery · Surgery of the HandTaxonomy 2086S0105X

204 WORCESTER ST, Wellesley, MA 02481

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Other Identifiers 3

Other600215MA · Tufts Health Plan

OtherM12935MA · Bcbs Group Number

Medicare ID-Type UnspecifiedM12935MA · Medicare Group Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASON TAN DPT

Physical Therapist (Orthopedic)