Organization Active NPI

Keris Dermatology ,PLLC

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1033268693
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
KERIS DERMATOLOGY ,PLLC
Practice address
166 5TH Ave
2ND FL.
New York, NY 10010-5909
Phone
(212) 229-0333
Fax
(646) 218-4133
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Dr. Sumayah Jamal, MD
Title
Gen.PTR
Phone
(212) 229-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

166 5TH Ave
2ND FL.
New York, NY 10010-5909

Mailing address

166 5TH Ave
2ND FL.
New York, NY 10010-5909
Phone (212) 229-0333

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1033268693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 5TH AVE",
            "address_2": "2ND FL.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105909",
            "telephone_number": "212-229-0333",
            "fax_number": "646-218-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 5TH AVE",
            "address_2": "2ND FL.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100105909",
            "telephone_number": "212-229-0333",
            "fax_number": "646-218-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERIS DERMATOLOGY ,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "JAMAL",
        "authorized_official_first_name": "SUMAYAH",
        "authorized_official_title_or_position": "GEN.PTR",
        "authorized_official_telephone_number": "212-229-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.