Organization Active NPI

Soho Skin and Laser Dermatology PC

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1093782492
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SOHO SKIN AND LASER DERMATOLOGY PC
Practice address
197 Grand St Ste 3E
New York, NY 10013-3859
Phone
(212) 431-7600
Fax
(212) 431-7521
NPI assigned
Mar 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Simon Samaha, M.D.NPI 1144304536
Title
Ceo
Phone
(973) 571-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
Multi-Specialty Clinic/Center 261QM1300X NY165531 NY

Addresses

Primary practice location

197 Grand St Ste 3E
New York, NY 10013-3859

Mailing address

347 Mount Pleasant Ave Ste 205
West Orange, NJ 07052-2749
Phone (973) 571-2121

Other practice location 1

62 Crosby St
New York, NY 10012-4410
Phone (212) 431-1600

Other names 1

  • SOHO SKIN & LASER DERMATOLOGY, PC Doing business as

National Provider Directory

National Provider Directory

Locations

142 Joralemon St
Ste 8A
Brooklyn Heights, NY 11201
Phone (212) 289-9191

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093782492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 MOUNT PLEASANT AVE STE 205",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522749",
            "telephone_number": "973-571-2121",
            "fax_number": "973-498-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 GRAND ST STE 3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133859",
            "telephone_number": "212-431-7600",
            "fax_number": "212-431-7521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Crosby St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100124410",
            "country_code": "US",
            "telephone_number": "212-431-1600",
            "fax_number": "212-431-7521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOHO SKIN AND LASER DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SAMAHA",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-571-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NY",
            "license": "NY165531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOHO SKIN & LASER DERMATOLOGY, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; 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.