Pioneer Dermatology, LLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

264404 Issued in NY

Legal business name

PIONEER DERMATOLOGY, LLC

Doing business as

Pura Dermatology, LLC

Practice address

446 W 38TH St
New York, NY 10018-2835

Phone

(212) 683-8306

Fax

(646) 395-1683

NPI assigned

Aug 29, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Saurabh Lodha, MDNPI 1083925051

Title

Owner

Phone

(212) 683-8306

Specialties & licenses 1

Addresses

Other names 1

• Pura Dermatology, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Saurabh Lodha, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1083925051
  Medicare reassignment Authorized official
• Leena A Brown, PT, PA-C

  • Physician Assistant
  • New York, NY
  • NPI 1629476486
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1023442720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 W 38TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182835",
            "telephone_number": "212-683-8306",
            "fax_number": "646-395-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 W 38TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100182835",
            "telephone_number": "212-683-8306",
            "fax_number": "646-395-1683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "LODHA",
        "authorized_official_first_name": "SAURABH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-683-8306",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NY",
            "license": "264404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pura Dermatology, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sofya Pintova, MD
• Marion Pinunggan
• Teeda Pinyavat, MD
• Kevin Johnathan Pinzone, M.S. L.AC.
• Nicholas M Piombino, LCSW
• David Pioquinto, MD
• Alexandra Piorkowski, LMHC
• Anna F. Piotrowski, M. D.
• Christine Aniela Pipchick, PA-C
• Brent Piper, M.A. MHC

• Dermatopathology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatopathology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.