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General NPI Number Information
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NPI Number | 1558171538
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Entity Type | Organization
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Legal Business Name | NEW YORK CITY SKIN LLC
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 1315 LORNA ST. #103
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City | CHARLOTTE
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State | NC
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Zip | 28205
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Country | US
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Telephone | 803-693-5123
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 EAST BLVD STE E
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City | CHARLOTTE
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State | NC
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Zip | 28203-5876
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Country | US
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Telephone | 803-693-5123
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARAH FRIERSON
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Credential | MMS, PA-C
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Telephone | 803-693-5123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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