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General NPI Number Information
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NPI Number | 1679992457
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Entity Type | Organization
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Legal Business Name | TZU DERMATOLOGY, P.C.
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 65 BROADWAY STE 904
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City | NEW YORK
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State | NY
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Zip | 10006-2523
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Country | US
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Telephone | 212-931-0538
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Fax | 212-430-3797
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Provider Business Mailing Address
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Address Line | 65 BROADWAY 904
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City | NEW YORK
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State | NY
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Zip | 10006-2523
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Country | US
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Telephone | 212-931-0538
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Fax | 212-430-3797
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JULIA TZU
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Credential | M.D.
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Telephone | 212-931-0538
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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 | 256102
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 256012
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 256102
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 256102
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License Number State | NY
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