Union Square Laser Dermatology

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

235121 Issued in NY

Legal business name

UNION SQUARE LASER DERMATOLOGY

Practice address

19 Union SQ W FL 5
New York, NY 10003-3304

Phone

(212) 366-5400

NPI assigned

Sep 16, 2011

Organization subpart

No

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

Authorized official

Name

Mr. David Scott

Title

Director

Phone

(212) 366-5400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anne M Chapas, M.D.

  • Specialist
  • New York, NY
  • NPI 1467417360
  Medicare reassignment Care Compare group NPD
• Tatyana Petukhova, M.D., M.S.

  • MOHS-Micrographic Surgery Physician
  • New York, NY
  • NPI 1528300878

  Procedural Dermatology

  Medicare reassignment Care Compare group NPD
• Nkemjika Ugonabo, M.D.

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
  • NPI 1447786991
  Medicare reassignment Care Compare group NPD
• Jennifer L Chwalek, MD

  • Dermatology Physician
  • Union City, CA
  • NPI 1407999667

  NY

  Medicare reassignment Care Compare group NPD
• Mitchell A Kline, M.D.

  • Specialist
  • New York, NY
  • NPI 1932136231
  Medicare reassignment NPD
• Yunyoung Claire Chang, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1639514847
  NPD (past)
• Robyn Gmyrek, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1487754792
  NPD (past)
• Shereene Idriss, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1295969624

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1487936308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 UNION SQ W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033304",
            "telephone_number": "212-366-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 UNION SQ W FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033304",
            "telephone_number": "212-366-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION SQUARE LASER DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-16",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-366-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "235121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Union Square Counseling LCSW P.C.
• Union Square Dental
• Union Square Eye Care LLC
• Union Square Eye Center LLC
• Union Square Gastroenterology, P.C.
• Union Square Medical Imaging and Mammography PC
• Union Square Medical Practice PC
• Union Square Optical, Inc
• Union Square Physical Therapy & Chiroprctic
• Union Square Psychotherapy, LCSW, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.