MEDICARE: DERMATOLOGY & SURGERY ASSOCIATES, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		NY
2	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1609991405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERMATOLOGY & SURGERY ASSOCIATES, LLP

Provider Business Mailing Address
First Line	:	PO BOX 682
Second Line	:	3620 E TREMONT AVENUE
City	:	BRONX
State	:	NY
Zip	:	10465
Country	:	US
Telephone Number	:	718-792-4700
Fax Number	:	718-828-1898

Provider Business Practice Location Address
First Line	:	3620 E TREMONT AVE
Second Line	:	2ND FLOOR
City	:	BRONX
State	:	NY
Zip	:	10465-2038
Country	:	US
Telephone Number	:	718-792-4700
Fax Number	:	718-828-1898

Authorized Official
Title or Position	:	MD
Name	:	EUGENE J WHANG
Credential	:
Telephone Number	:	718-792-4700

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/21/2022

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