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General NPI Number Information
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NPI Number | 1225918220
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Entity Type | Organization
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Legal Business Name | RM DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 700 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10021-0104
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Country | US
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Telephone | 212-517-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 66TH ST APT E507
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City | NEW YORK
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State | NY
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Zip | 10065-9192
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Country | US
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Telephone | 202-306-2472
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RADHA MIKKILINENI
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Credential | MD
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Telephone | 202-306-2472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology 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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