Healthcare Provider Details

I. General information

NPI: 1457326514
Provider Name (Legal Business Name): HMT DERMATOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 10/27/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5783 WOOSTER PIKE
MEDINA OH
44256
US

IV. Provider business mailing address

5783 WOOSTER PIKE
MEDINA OH
44256
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-0569
  • Fax: 330-662-0258
Mailing address:
  • Phone: 330-725-0569
  • Fax: 330-662-0258

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

VIII. Authorized Official

Name: DR. HELEN M TOROK
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: MD
Phone: 330-725-0569