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Deactivated NPI 1639172679 Deactivated / Inactive NPI Male Practitioner

Dr. Lyle Marnin Back , MD

Plastic Surgery • Cherry Hill, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Lyle Back has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 23, 2005
NPI Deactivation Date March 15, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Lyle Back, MD was a registered Plastic Surgery practicing in Cherry Hill, NJ. Throughout an active medical career spanning 1 years, Dr. Back provided care at the practice location at 1942 ROUTE 70 E until profile deactivation on 2006-03-15.

Practice Location & Contact Primary Location

Practice Address

1942 Route 70 E

Cherry Hill, NJ 080032118

Telephone 8567517550
Fax 8567517544
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Cherry Hill, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 31.2 Yrs
Regional Practice Density
5 Specialists

Practicing in Cherry Hill, NJ (209 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License NJ MA046399

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Demetria Smith , CST

Specialist/Technologist, Other - Surgical Technologist

NPI 1831805944

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 1942 ROUTE 70 E, CHERRY HILL, NJ 080032118 (Tel: 8567517550)

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Updated Business Mailing Address July 08, 2007

Registered at 1942 ROUTE 70 E, CHERRY HILL, NJ 080032118 (Tel: 8567517550)

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Provider Name / Credentials Updated July 08, 2007

Recorded as LYLE BACK, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Plastic Surgery (License #MA046399 in NJ)

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NPI Profile Reactivated March 29, 2006

Record officially reactivated for active practice on March 29, 2006

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NPI Profile Deactivated March 15, 2006

Record deactivated on March 15, 2006

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Initial NPI Registration & Enumeration May 23, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639172679
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 23, 2005
Last Update: July 08, 2007
Deactivation Date: March 15, 2006
Sole Proprietor: Yes

Mailing Address

1942 Route 70 E

Cherry Hill, NJ 080032118

Phone: 8567517550

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.