| NPI | 1568413169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENA SIMPSON A VP Credentialing 646-680-2894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207P00000X Emergency Medicine | |
| 207Q00000X Family Medicine | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 207RH0003X Internal Medicine Hematology & Oncology | |
| 207W00000X Ophthalmology | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 208600000X Surgery | |
| 208800000X Urology | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery | |
| 207NS0135X Dermatology Procedural Dermatology | |
| 207NP0225X Dermatology Pediatric Dermatology | |
| 207ND0900X Dermatology Dermatopathology | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-12-01 |