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General NPI Number Information
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NPI Number | 1992725279
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Entity Type | Organization
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Legal Business Name | ADVANCED DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 301 HURLEY AVE
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City | KINGSTON
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State | NY
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Zip | 12401-2416
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Country | US
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Telephone | 845-339-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 301 HURLEY AVE
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City | KINGSTON
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State | NY
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Zip | 12401-2416
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Country | US
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Telephone | 845-339-2525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH T KIRCHER
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Credential | D.O.
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Telephone | 845-339-2525
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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 |
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License Number State |
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