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General NPI Number Information
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NPI Number | 1437462454
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Entity Type | Organization
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Legal Business Name | ART OF DERMATOLOGY, LLC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 860 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10065-5856
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Country | US
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Telephone | 212-488-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 860 5TH AVE GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10065-5856
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Country | US
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Telephone | 212-488-5599
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Fax | 212-488-5557
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Authorized Official
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Title or Position | OWNER, ART OF DERMATOLOGY LLC
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Name | DR. JESSICA J. KRANT
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Credential | M.D., M.P.H.
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Telephone | 212-488-5599
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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 | 220067-1
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License Number State | NY
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