| NPI | 1831542661 |
|---|---|
| Doing Business As | PLAZA PARK DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | TOBECHI EBEDE Medical Director 718-522-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 245700) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NY 245700) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: NY 245700) | |
| Enumeration Date | 2016-07-17 |
| Last Update Date | 2016-07-17 |