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General NPI Number Information
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NPI Number | 1801258413
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY LASER GROUP, PLLC.
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 110 E 60TH STREET SUITE 606
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City | NEW YORK
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State | NY
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Zip | 10022
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Country | US
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Telephone | 212-444-8204
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Fax | 646-861-6539
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Provider Business Mailing Address
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Address Line | 200 W 57TH ST SUITE 510
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City | NEW YORK
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State | NY
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Zip | 10019-3211
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Country | US
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Telephone | 212-444-8204
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Fax | 646-861-6139
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Authorized Official
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Title or Position | OWNER
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Name | ARASH AKHAVAN
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Credential | MD
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Telephone | 212-444-8204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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