Philip Bruder MD, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PHILIP BRUDER MD, PC

Practice address

245 E 63Rd St
Suite 107
New York, NY 10021-7466

Phone

(212) 980-9292

Fax

(212) 752-0674

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Mila Minevich

Title

Billing Manager

Phone

(212) 980-9292

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316984297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 E 63RD ST",
            "address_2": "SUITE 107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100217466",
            "telephone_number": "212-980-9292",
            "fax_number": "212-752-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E 63RD ST",
            "address_2": "SUITE 107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100217466",
            "telephone_number": "212-980-9292",
            "fax_number": "212-752-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP BRUDER MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MINEVICH",
        "authorized_official_first_name": "MILA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "212-980-9292",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology 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.