is a Dermatology in Massapequa, New York. practices all healthcare services and medical treatments related to Dermatology. The NPI Number for is 1184735193. The last update date is .
's current location address is 70 Grand Ave, Massapequa, New York. You can contact this provider via phone number 5167991600 and fax number 5167991454. The mailing address for is 70 Grand Ave, Massapequa, New York. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 70 Grand Ave, Massapequa, New York |
Phone Number | 5167991600 |
Fax Number | 5167991454 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1184735193 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 70 Grand Ave |
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City | Massapequa |
State | New York (NY) |
Post Code | 117584906 |
Phone Number | 5167991600 |
Fax Number | 5167991454 |
Provider's Primary Taxonomy Detail
Speciality | Dermatology |
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Taxonomy | 207N00000X |
Licence No | 171086 |
Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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1503988 | NY | -- |
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