Healthcare Provider Details

I. General information

NPI: 1316331762
Provider Name (Legal Business Name): MARGO LEDERHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 HARWOOD CT STE 217
SCARSDALE NY
10583-4120
US

IV. Provider business mailing address

4 BIRCH RD
LARCHMONT NY
10538-1527
US

V. Phone/Fax

Practice location:
  • Phone: 914-472-4100
  • Fax:
Mailing address:
  • Phone: 215-964-4063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number299120
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number299120
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: