Northeast Breast Reconstruction LLC
NPI 1255879748 · Plastic and Reconstructive Surgery Physician · Southport, CT
Northeast Breast Reconstruction LLC is a Plastic and Reconstructive Surgery Physician organization in Southport, CT (NPI 1255879748).
Provider details
- NPI number
- 1255879748
- Entity type
- Organization
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Shareef Jandali, Owner(718) 672-2824
- License
- 25MA10021400 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-02-06
- Last updated
- 2017-02-06
Frequently asked questions
- What is Northeast Breast Reconstruction LLC's NPI number?
- Northeast Breast Reconstruction LLC's National Provider Identifier (NPI) is 1255879748, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northeast Breast Reconstruction LLC?
- Northeast Breast Reconstruction LLC is classified in the NPPES registry as Plastic and Reconstructive Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Northeast Breast Reconstruction LLC located?
- Northeast Breast Reconstruction LLC's practice location on file with NPPES is 21 Southport Terrace, Southport, CT 06890.
- What is Northeast Breast Reconstruction LLC's phone number?
- The practice phone number listed in the NPPES registry for Northeast Breast Reconstruction LLC is (718) 672-2824.
- Who is the authorized official for Northeast Breast Reconstruction LLC?
- The authorized official listed on Northeast Breast Reconstruction LLC's NPPES record is Shareef Jandali, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northeast Breast Reconstruction LLC's NPI active?
- Yes — Northeast Breast Reconstruction LLC's NPI (1255879748) is active in the NPPES registry as of the last update on 2017-02-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.