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General NPI Number Information
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NPI Number | 1033818208
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Entity Type | Organization
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Legal Business Name | AN DERMATOLOGY OF NEW YORK P C
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 110 E 40TH ST RM 703
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City | NEW YORK
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State | NY
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Zip | 10016-1806
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Country | US
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Telephone | 516-945-9346
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Fax | 231-216-7895
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Provider Business Mailing Address
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Address Line | 15 THE PNES
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City | OLD WESTBURY
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State | NY
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Zip | 11568-1126
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Country | US
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Telephone | 516-945-9346
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Fax | 231-216-7895
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Authorized Official
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Title or Position | CEO
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Name | DR. ADAM NABATIAN
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Credential | MD
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Telephone | 516-945-9346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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