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General NPI Number Information
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NPI Number | 1639332281
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Entity Type | Organization
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Legal Business Name | BAY RIDGE SKIN AND CANCER DERMATOLOGY, PC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 9921 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-8347
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Country | US
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Telephone | 718-833-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 9921 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-8347
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Country | US
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Telephone | 718-833-7616
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID BIRO
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Credential | MD
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Telephone | 718-833-7616
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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 | 194876
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License Number State | NY
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