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Contact Information

NEW YORK DERMATOLOGY & MOHS SURGERY GROUP, PLLC
353 VETERANS MEMORIAL HIGHWAY
COMMACK, NY11725
 Phone: 631-543-4888
 Fax: 631-543-3549
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Pediatric Dermatology

207NP0225X 07 Physician/Dermatology
 

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for NEW YORK DERMATOLOGY MOHS SURGERY GROUP PLLC · (Female)

NPI Number 1851555122
Status Active
Credentials
Entity Individual
Enumeration date 07/15/2008
Last updated 07/03/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 205536-1
  • NY License # 222859
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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