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General NPI Number Information
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NPI Number | 1790086585
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Entity Type | Organization
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Legal Business Name | SKIN SOLUTIONS DERMATOLOGY P.C.
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 12 HEMPSTEAD AVE #3-S
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4010
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Country | US
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Telephone | 646-522-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 12 HEMPSTEAD AVE #3-S
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4010
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Country | US
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Telephone | 646-522-2383
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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. JAMES JOSEPH BRILEY JR.
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Credential | D.O.
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Telephone | 646-522-2383
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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 | 230328
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License Number State | NY
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