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General NPI Number Information
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NPI Number | 1245414259
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Entity Type | Organization
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Legal Business Name | NORTH SHORE DERMATOLOGY ASSOCIATES,P.C.
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 2 HILLSIDE AVE SUITE G
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2392
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Country | US
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Telephone | 516-747-2230
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Fax | 516-747-1087
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Provider Business Mailing Address
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Address Line | 2 HILLSIDE AVE SUITE G
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2392
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Country | US
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Telephone | 516-747-2230
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Fax | 516-747-1087
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT L PALTZIK
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Credential | M.D.
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Telephone | 516-747-2230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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