NPIMap

Organization Active NPI

Southern Tier Dermatology & Aesthetics

  • Dermatology Physician
  • Endwell, NY
National Provider Identifier
1275589558
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SOUTHERN TIER DERMATOLOGY & AESTHETICS
Practice address
333 Hooper Rd.
Endwell, NY 13760
Phone
(607) 729-2776
Fax
(607) 729-2773
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Authorized official

Name
Nancy Leftenant
Title
Mar.
Phone
(607) 729-2777

Specialties & licenses 1

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

Addresses

Primary practice location

333 Hooper Rd.
Endwell, NY 13760

Mailing address

333 Hooper Rd
Endwell, NY 13760
Phone (607) 729-2776

National Provider Directory

National Provider Directory

Locations

950 County Road 64
Ste 100
Elmira, NY 14903
Phone (607) 796-5900

950 County Road 64
Elmira, NY 14903
Phone (607) 796-5900

4535 Southwestern Blvd
Ste 202
Hamburg, NY 14075
Phone (607) 729-2777

774 Fairmount Ave
Jamestown, NY 14701
Phone (716) 338-0668

320 Prather Ave
Ste 300B
Jamestown, NY 14701

6 Rhoads Dr
Ste 1
Utica, NY 13502

Practitioners & affiliated clinicians

Practitioners 10

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": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1275589558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 HOOPER RD",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "13760",
            "telephone_number": "607-729-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HOOPER RD.",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "13760",
            "telephone_number": "607-729-2776",
            "fax_number": "607-729-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER DERMATOLOGY & AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "LEFTENANT",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "MAR.",
        "authorized_official_telephone_number": "607-729-2777"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endwell, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.