Organization · NPI-2

Advanced Dermatology PC

Dermatology · New York, NY

NPI number1497921795

StatusActive

Last updated in NPPESMay 6, 2008

Details

NPI: 1497921795
Entity type: Organization (NPI-2)
Legal business name: Advanced Dermatology PC
Organization subpart: No
Enumeration date: May 6, 2008
Last updated: May 6, 2008

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207N00000X	Dermatology	–	–	Yes
207ND0101X	Dermatology, MOHS-Micrographic Surgery	–	–
207ND0900X	Dermatology, Dermatopathology	–	–
208200000X	Plastic Surgery	–	–

Practice location

130 W 86th St
New York, NY 10024-4040

Phone 212-787-2929 · Fax 212-787-3077

Mailing address

6 Lowell Ave
New Hyde Park, NY 11040-2810

Phone 516-326-4160 · Fax 516-437-0482

Authorized official

Lewis Lippner
Administrator
5163264160

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