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General NPI Number Information
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NPI Number | 1134236722
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF HUNTINGTON, PC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 177 MAIN ST SUITE #105
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City | HUNTINGTON
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State | NY
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Zip | 11743-6917
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Country | US
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Telephone | 631-421-4188
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Fax | 631-421-4197
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Provider Business Mailing Address
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Address Line | 177 MAIN ST
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City | HUNTINGTON
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State | NY
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Zip | 11743-6917
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Country | US
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Telephone | 631-421-4188
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Fax | 631-421-4197
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSAN TIMONEY
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Credential |
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Telephone | 631-421-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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