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General NPI Number Information
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NPI Number | 1942150131
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Entity Type | Organization
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Legal Business Name | LASERDERM DERMATOLOGY & COSMETIC LASER SURGERY
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 327 E MAIN ST
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City | SMITHTOWN
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State | NY
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Zip | 11787-2905
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Country | US
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Telephone | 631-979-0909
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Fax | 631-979-0455
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Provider Business Mailing Address
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Address Line | 327 E MAIN ST
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City | SMITHTOWN
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State | NY
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Zip | 11787-2905
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Country | US
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Telephone | 631-979-0909
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Fax | 631-979-0455
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Authorized Official
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Title or Position | COO
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Name | MR. DAVID SERURE
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Credential |
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Telephone | 917-868-2783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number |
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License Number State |
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