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General NPI Number Information
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NPI Number | 1801002456
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE DERMATOLOGY, P.C.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 65 HICKORY RD # B
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-1517
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Country | US
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Telephone | 516-712-9337
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Fax | 516-294-4569
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Provider Business Mailing Address
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Address Line | 65 HICKORY RD # B
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-1517
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Country | US
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Telephone | 516-712-9337
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Fax | 516-294-4569
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ROBIN BETH SEPTON
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Credential | M.D.
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Telephone | 516-712-9337
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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 | 233325-1
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License Number State | NY
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