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General NPI Number Information
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NPI Number | 1568649713
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Entity Type | Organization
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Legal Business Name | CRAIG AUSTIN DERMATOLOGY PC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 200 WESTAGE BUSINESS CTR DR STE 231
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City | FISHKILL
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State | NY
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Zip | 12524-2268
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Country | US
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Telephone | 845-896-6669
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Fax |
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Provider Business Mailing Address
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Address Line | 200 WESTAGE BUSINESS CTR DR SUITE 231
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City | FISHKILL
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State | NY
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Zip | 12524-2264
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Country | US
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Telephone | 845-896-6669
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. MICHAEL G CORRIGAN
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Credential |
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Telephone | 516-542-0891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1702401
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License Number State | NY
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