Advanced Dermatology PC
Organization Active NPI Dermatology Physician · West Islip, NY
NPI 1043486319 · NPPES record last updated May 6, 2008
Key facts
- NPI
- 1043486319
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- ADVANCED DERMATOLOGY PC
- Practice address
- 510 Montauk Hwy
West Islip, NY 11795-4422 - Phone
- (631) 587-1132
- Fax
- (631) 422-4922
- NPI assigned
- May 6, 2008
- Organization subpart
- No
Authorized official
- Name
- Lewis Lippner
- Title
- Administrator
- Phone
- (516) 326-4160
Corporate family (same tax ID) 4
Practitioners 1
-
Joshua L Fox, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D1008584 | Advanced Dermatology PC | Compliance | May 14, 2027 |
National Provider Directory
- Tax ID family
- Advanced Dermatologypc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| MOHS-Micrographic Surgery Physician |
207ND0101X | |||
| Dermatopathology Physician |
207ND0900X | |||
| Plastic Surgery Physician |
208200000X |
Addresses
Primary practice location
510 Montauk Hwy
West Islip, NY 11795-4422
Mailing address
6 Lowell Ave
New Hyde Park, NY 11040-2810
Phone (516) 326-4160
Other providers in West Islip, NY
- Jenny Elizabeth Abraham
- Abu Muhammad M. Haque M.D.P.C.
- Almothana Aburumman
- Rosemary Accomando
- Molave Agana Adaniel
- Hakeem Afuwape
- Amy Agiato
- Samantha Ahearn
- Michele Ahlers
- Fahim Shan Ahmed
All providers in West Islip, NY · Dermatology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.