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General NPI Number Information
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NPI Number | 1861941320
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Entity Type | Organization
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Legal Business Name | JODY KONSTADT DERMATOLOGY PLLC
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 700 WHITE PLAINS RD SUITE 30
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City | SCARSDALE
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State | NY
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Zip | 10583-5063
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Country | US
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Telephone | 914-725-3700
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Fax | 914-725-3885
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Provider Business Mailing Address
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Address Line | 30 CENTRAL PARK S SUITE 10A
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City | NEW YORK
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State | NY
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Zip | 10019-1628
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Country | US
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Telephone | 914-725-3700
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Fax | 914-725-3885
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Authorized Official
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Title or Position | OWNER
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Name | JODY KONSTADT
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Credential | MD
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Telephone | 914-725-3700
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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 |
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