The Center for Dermatologic Surgery of Monroe

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

154268 Issued in NY

Legal business name

THE CENTER FOR DERMATOLOGIC SURGERY OF MONROE

Practice address

503 State Route 208
Monroe, NY 10950-1619

Phone

(845) 783-2920

Fax

(845) 783-2918

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Yehuda David Eliezri, M.D.

Title

President

Phone

(845) 783-2920

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255415113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 STATE ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501619",
            "telephone_number": "845-783-2920",
            "fax_number": "845-783-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 STATE ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109501619",
            "telephone_number": "845-783-2920",
            "fax_number": "845-783-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR DERMATOLOGIC SURGERY OF MONROE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELIEZRI",
        "authorized_official_first_name": "YEHUDA",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-783-2920",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "154268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Pelham Tedeschi, MS.ED
• Martin Teich, RPH
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• Sharon Tepfer Rubin, MS CCC/SLP
• Sandra L Tetler, FNP
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• MOHS-Micrographic Surgery Physician in Monroe, NY
• Providers in Monroe, NY by specialty
• MOHS-Micrographic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.