Healthcare Provider Details

I. General information

NPI: 1003663204
Provider Name (Legal Business Name): ACS DERMATOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8316 ARLINGTON BLVD
FAIRFAX VA
22031-5207
US

IV. Provider business mailing address

4619 FOXHALL CRES NW
WASHINGTON DC
20007-1061
US

V. Phone/Fax

Practice location:
  • Phone: 215-272-8391
  • Fax:
Mailing address:
  • Phone: 304-685-3629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS HYLAND CRONIN
Title or Position: PRESIDENT/MEMBER
Credential: MD
Phone: 304-685-3629