MEDICARE: LANCASTER DERMATOLOGY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	172021	NY

General Provider Information

NPI Number	:	1790069797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANCASTER DERMATOLOGY, PLLC

Provider Business Mailing Address
First Line	:	1821 COMO PARK BLVD
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-2823
Country	:	US
Telephone Number	:	716-681-4800
Fax Number	:	716-681-3713

Provider Business Practice Location Address
First Line	:	1821 COMO PARK BLVD
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-2823
Country	:	US
Telephone Number	:	716-681-4800
Fax Number	:	716-681-3713

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. CHRISTOPHER DABSKI
Credential	:	MD
Telephone Number	:	716-681-4800

Provider Enumeration Date	:	10/09/2011
Last Update Date	:	10/09/2011

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