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General NPI Number Information
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NPI Number | 1275353716
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Entity Type | Organization
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Legal Business Name | DERMATOLOGIC SERVICES PLLC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 415 RED HOOK LN APT 4D
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City | BROOKLYN
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State | NY
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Zip | 11201-5132
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Country | US
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Telephone | 832-766-4074
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Fax |
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Provider Business Mailing Address
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Address Line | 415 RED HOOK LN APT 4D
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City | BROOKLYN
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State | NY
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Zip | 11201-5132
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Country | US
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Telephone | 832-766-4074
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | GIBRAN SHAIKH
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Credential | MD
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Telephone | 832-766-4074
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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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