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General NPI Number Information
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NPI Number | 1700051158
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Entity Type | Organization
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Legal Business Name | NSS DERMATOLOGY PLLC
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 150 W 55TH ST #GF
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City | NEW YORK
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State | NY
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Zip | 10019-5305
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Country | US
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Telephone | 212-991-6490
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Fax | 646-349-2493
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Provider Business Mailing Address
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Address Line | 150 W 55TH ST FRNT 1G
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City | NEW YORK
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State | NY
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Zip | 10019-5586
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Country | US
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Telephone | 212-991-6490
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Fax | 646-349-2493
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LIBBY RHEE
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Credential |
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Telephone | 212-433-4569
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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 | 211528
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License Number State | NY
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