Healthcare Provider Details

I. General information

NPI: 1225433246
Provider Name (Legal Business Name): DERMATOLOGY ASSOCIATES OF NEW YORK, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2014
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 MAMARONECK AVE SUITE 412
HARRISON NY
10528-2418
US

IV. Provider business mailing address

440 MAMARONECK AVE SUITE 412
HARRISON NY
10528-2418
US

V. Phone/Fax

Practice location:
  • Phone: 914-777-1799
  • Fax: 914-777-1899
Mailing address:
  • Phone: 914-777-1799
  • Fax: 914-777-1899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number217867
License Number StateNY

VIII. Authorized Official

Name: DR. DEBBIE MERAL PALMER
Title or Position: MANAGING PARTNER
Credential: D.O.
Phone: 914-777-1799