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Contact Information

LASERDERM DERMATOLOGY & COSMETIC LASER SURGERY
327 E MAIN ST
SMITHTOWN, NY11787-2905
 Phone: 631-979-0909
 Fax: 631-979-0455
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatopathology

207ND0900X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for LASERDERM DERMATOLOGY COSMETIC LASER SURGERY · (Female)

NPI Number 1942150131
Status Active
Credentials
Entity Individual
Enumeration date 01/29/2026
Last updated 01/29/2026 - About 4 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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