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General NPI Number Information
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NPI Number | 1659417038
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE DERMATOLOGY, P.C.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 1122 BROADWAY
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City | WOODMERE
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State | NY
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Zip | 11598-1242
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Country | US
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Telephone | 516-295-3838
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Fax | 516-295-4976
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Provider Business Mailing Address
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Address Line | 1122 BROADWAY
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City | WOODMERE
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State | NY
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Zip | 11598-1242
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Country | US
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Telephone | 516-295-3838
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Fax | 516-295-4976
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Authorized Official
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Title or Position | OWNER
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Name | DR. ABRAHAM I ABITTAN
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Credential | M.D.
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Telephone | 516-295-3838
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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 | 187786
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License Number State | NY
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