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Contact Information

ISLAND DERMATOLOGY, PC
604 E PARK AVE
LONG BEACH, NY11561-2505
 Phone: 516-432-0011
 Fax: 516-432-1686
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for ISLAND DERMATOLOGY PC · (Female)

NPI Number 1316996937
Status Active
Credentials
Entity Individual
Enumeration date 05/09/2006
Last updated 07/05/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY Medicaid 01453341
  • Other 14478 AETNA,USHEALTHCARE
  • Other 373723 AMERIHEALTH
  • Other W23131 BLUE CROSS/BLUE SHIELD
  • Other 2200149 GHI
  • Other 7374 VYTRA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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