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General NPI Number Information
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NPI Number | 1295969624
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Entity Type | Individual
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Provider Name | SHEREENE IDRISS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | IDRISS DERMATOLOGY 80 W 40TH ST, 3RD FLOOR
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City | NEW YORK
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State | NY
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Zip | 10018-2682
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Country | US
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Telephone | 212-612-1520
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Fax | 332-216-3520
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Provider Business Mailing Address
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Address Line | 80 W 40TH ST FLOOR 3
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City | NEW YORK
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State | NY
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Zip | 10018-2682
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Country | US
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Telephone | 212-612-1520
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Fax | 332-216-3520
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 269568-1
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License Number State | NY
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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 | 269568
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License Number State | NY
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