NPIMap

Organization Active NPI

Clark Dermatology, LLC

Doing business as Metropolitan Dermatology

  • Dermatology Physician
  • Staten Island, NY
National Provider Identifier
1417316274
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CLARK DERMATOLOGY, LLC
Doing business as
Metropolitan Dermatology
Practice address
1324 Victory Blvd
Staten Island, NY 10301-3917
Phone
(718) 448-4488
NPI assigned
Feb 22, 2016
Last updated
May 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Alexander Doctoroff, D.ONPI 1881648970
Title
Owner
Phone
(732) 574-1399

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU
Dermatopathology Physician 207ND0900X NU

Addresses

Primary practice location

1324 Victory Blvd
Staten Island, NY 10301-3917

Mailing address

469 Morris Ave Ste 3
Elizabeth, NJ 07208-2904
Phone (732) 574-1399

Other names 1

  • Metropolitan Dermatology Doing business as

National Provider Directory

National Provider Directory

Locations

1075 Central Ave
Clark, NJ 07066
Phone (732) 574-1399

1324 Victory Blvd
Staten Island, NY 10301
Phone (718) 448-4488

Practitioners & affiliated clinicians

Practitioners 81

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.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1417316274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 MORRIS AVE STE 3",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082904",
            "telephone_number": "732-574-1399",
            "fax_number": "908-512-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013917",
            "telephone_number": "718-448-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "DOCTOROFF",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-574-1399",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metropolitan Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.