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General NPI Number Information
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NPI Number | 1174397566
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Entity Type | Organization
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Legal Business Name | CITRUS DERMATOLOGY SERVICES OF MD PC
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 5000 THAYER CTR STE C
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City | OAKLAND
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State | MD
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Zip | 21550-1139
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Country | US
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Telephone | 516-388-7209
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Fax | 877-413-4836
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Provider Business Mailing Address
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Address Line | 5000 THAYER CTR STE C
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City | OAKLAND
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State | MD
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Zip | 21550-1139
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Country | US
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Telephone | 516-388-7209
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Fax | 877-413-4836
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Authorized Official
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Title or Position | PC PRESIDENT
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Name | RACHEL DAY
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Credential | MD
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Telephone | 201-819-4588
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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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