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General NPI Number Information
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NPI Number | 1699955013
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Entity Type | Organization
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Legal Business Name | BRONX DERMATOLOGY
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 553 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5046
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Country | US
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Telephone | 718-329-2959
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Fax | 718-329-6333
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Provider Business Mailing Address
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Address Line | 553 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5046
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Country | US
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Telephone | 718-329-2959
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Fax | 718-329-6333
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD ALFRED SAVITZ
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Credential | M.D
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Telephone | 718-329-2959
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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 | 198261
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License Number State | NY
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