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General NPI Number Information
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NPI Number | 1912923400
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Entity Type | Organization
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Legal Business Name | BELLMORE DERMATOLOGY PLLC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 2351 BEDFORD AVE
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City | BELLMORE
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State | NY
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Zip | 11710-3627
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Country | US
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Telephone | 516-781-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 2351 BEDFORD AVE
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City | BELLMORE
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State | NY
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Zip | 11710-3627
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIMITRIA PAPADOPOULOS
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Credential | DO
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Telephone | 516-781-5070
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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 | 219163
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License Number State | NY
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