Healthcare Provider Details

I. General information

NPI: 1174397566
Provider Name (Legal Business Name): CITRUS DERMATOLOGY SERVICES OF MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST STE 201
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST STE 201
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 516-388-7209
  • Fax: 877-413-4836
Mailing address:
  • Phone: 516-388-7209
  • Fax: 877-413-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: RACHEL DAY
Title or Position: PC PRESIDENT
Credential: MD
Phone: 201-819-4588