Healthcare Provider Details

I. General information

NPI: 1508067463
Provider Name (Legal Business Name): ALLEN NATOW MD, IRENE ROSENBERG MD & IRA PION MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 03/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 CENTRAL AVE
WOODMERE NY
11598-1204
US

IV. Provider business mailing address

949 CENTRAL AVE
WOODMERE NY
11598-1204
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-1921
  • Fax: 516-295-9304
Mailing address:
  • Phone: 516-295-1921
  • Fax: 516-295-9304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IRENE ELAINE ROSENBERG
Title or Position: VICE-PRESIDENT
Credential: M.D.
Phone: 516-295-1921