NPI | 1609103522 |
---|---|
Entity Type | Organization |
Authorized Contact | KATIE LEE LAVE Billing/Office Manager 631-265-2928 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 083410) |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 083410) |
207NS0135X Dermatology, Procedural Dermatology (Licence: NY 083410) | |
Enumeration Date | 2009-11-13 |
Last Update Date | 2010-01-27 |