NPIMap

Organization Active NPI

Washington Square Dermatology

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1205376530
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
020662 Issued in NY
Legal business name
WASHINGTON SQUARE DERMATOLOGY
Practice address
18 Washington Square North
New York, NY 10011
Phone
(212) 256-1075
NPI assigned
Mar 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Authorized official

Name
Dr. Samer Jaber, MDNPI 1942343769
Title
Founder
Phone
(212) 256-1075

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 020662 NY Primary

Addresses

Primary practice location

18 Washington Square North
New York, NY 10011

Mailing address

2 5TH Ave
Unit 2
New York, NY 10011-8856

National Provider Directory

National Provider Directory
Tax ID family
Washington Square Dermatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1205376530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 5TH AVE",
            "address_2": "UNIT 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WASHINGTON SQUARE NORTH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "212-256-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON SQUARE DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "JABER",
        "authorized_official_first_name": "SAMER",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "212-256-1075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "020662",
            "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 Mar 6, 2017; 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.