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Contact Information

MARIWALLA DERMATOLOGY, PLLC
1253 MONTAUK HWY
WEST ISLIP, NY11795-4916
 Phone: 631-665-3376
 Fax: 631-969-3376
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for MARIWALLA DERMATOLOGY PLLC · (Female)

NPI # 1891094322
Status Active
Credentials
Entity Individual
Enumeration date 03/23/2011
Last updated 04/20/2017 - About 9 years 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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