NPIMap

Organization Active NPI

Advanced Dermatology of the Bronx PC

Doing business as Advanced Dermatology Associates

  • Specialist
  • Bronx, NY
National Provider Identifier
1477863876
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ADVANCED DERMATOLOGY OF THE BRONX PC
Doing business as
Advanced Dermatology Associates
Practice address
291 E 149TH St
Bronx, NY 10451-5601
Phone
(718) 742-1000
Fax
(212) 765-3210
NPI assigned
Oct 19, 2010
Last updated
Oct 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Lawrence D Jaeger, D.ONPI 1093711897
Title
Medical Director
Phone
(212) 262-2500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

291 E 149TH St
Bronx, NY 10451-5601

Mailing address

200 Central Park S
Suite 107
New York, NY 10019-1436
Phone (212) 262-2500

Other names 1

  • Advanced Dermatology Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1477863876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CENTRAL PARK S",
            "address_2": "SUITE 107",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191436",
            "telephone_number": "212-262-2500",
            "fax_number": "212-765-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515601",
            "telephone_number": "718-742-1000",
            "fax_number": "212-765-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY OF THE BRONX PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-262-2500",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.