Organization · NPI-2

Associates In Dermatology And Cosmetic Surgery-The Millburn Laser Cent

Dermatology · Bronx, NY

NPI number1336745330

StatusActive

Last updated in NPPESDec 7, 2020

Details

NPI: 1336745330
Entity type: Organization (NPI-2)
Legal business name: Associates In Dermatology And Cosmetic Surgery-The Millburn Laser Cent
Organization subpart: No
Enumeration date: Dec 7, 2020
Certification date: Dec 7, 2020
Last updated: Dec 7, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207N00000X	Dermatology	–	–	Yes
207ND0101X	Dermatology, MOHS-Micrographic Surgery	–	–

Practice location

3620 E Tremont Ave
Bronx, NY 10465-2038

Phone 718-792-4700

Mailing address

3620 E Tremont Ave
Bronx, NY 10465-2038

Phone 718-792-4700

Authorized official

Eric Scott Siegel
Owner
9733768500

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