Active Dermatology PLLC
Dermatology in Brooklyn, NY. Organization (NPI-2).
NPI number1720750573
StatusActive
Last updated in NPPESSep 27, 2022
Details
- NPI
- 1720750573
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Dermatology PLLC
- Organization subpart
- No
- Enumeration date
- Sep 30, 2021
- Certification date
- Sep 27, 2022
- Last updated
- Sep 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
Practice location
488 Decatur St Apt 2Brooklyn, NY 11233-6682
Phone 201-743-9134 · Fax 816-400-0441
Mailing address
488 Decatur St Apt 2Brooklyn, NY 11233-6682
Phone 201-743-9134 · Fax 816-400-0441
Authorized official
Camille Howard-Verovic
Owner
2017439134
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