Dermedx Dermatology PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

195658 Issued in NY

Legal business name

DERMEDX DERMATOLOGY PC

Practice address

222 E Main St
Suite 228
Smithtown, NY 11787-2871

Phone

(631) 265-1351

Fax

(631) 265-9363

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Barry A Solomon, M.D., J.D.

Title

President

Phone

(631) 265-1351

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Dermatique Doing business as

Locations

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1104944032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST",
            "address_2": "SUITE 228",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872871",
            "telephone_number": "631-265-1351",
            "fax_number": "631-265-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST",
            "address_2": "SUITE 228",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872871",
            "telephone_number": "631-265-1351",
            "fax_number": "631-265-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMEDX DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-265-1351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., J.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "195658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740242031",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01785368",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL #",
            "identifier": "110501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "W17942",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Demar13 LLC
• Jessica Lynn Demarco, LMSW
• John S Demarco, RPAC
• Dana Demarzo
• Lindsey Rose Denninger, LMSW
• Ruth Reed Derosa, PH.D.
• Laura Desilva
• Vincent Louis Desimone, LCSW
• Heather Destefano
• Nicole Dettling

• Specialist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.