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General NPI Number Information
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NPI Number | 1598225260
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY LASER AND SURGERY OF CARNEGIE HILL PLLC
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1095 PARK AVE STE 1A
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City | NEW YORK
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State | NY
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Zip | 10128-1154
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Country | US
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Telephone | 212-982-8229
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Fax | 646-792-3301
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Provider Business Mailing Address
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Address Line | 1095 PARK AVE # 1A
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City | NEW YORK
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State | NY
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Zip | 10128-1154
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Country | US
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Telephone | 212-982-8229
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Fax | 646-792-3301
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Authorized Official
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Title or Position | MANAGER
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Name | ANGELA LASORSA
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Credential |
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Telephone | 212-982-8229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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