Advanced Dermatology PC

Organization Active NPI Dermatology Physician · New York, NY

NPI 1497921795 · NPPES record last updated May 6, 2008

Key facts

NPI
1497921795
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
ADVANCED DERMATOLOGY PC
Practice address
130 W 86TH St
New York, NY 10024-4040
Phone
(212) 787-2929
Fax
(212) 787-3077
NPI assigned
May 6, 2008
Organization subpart
No

Authorized official

Name
Lewis Lippner
Title
Administrator
Phone
(516) 326-4160

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

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

National Provider Directory

Tax ID family
Advanced Dermatologypc (5 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207N00000X Yes
MOHS-Micrographic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207ND0101X
Dermatopathology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207ND0900X
Plastic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208200000X

Addresses

Primary practice location

130 W 86TH St
New York, NY 10024-4040

Mailing address

6 Lowell Ave
New Hyde Park, NY 11040-2810
Phone (516) 326-4160

Other providers in New York, NY

All providers in New York, NY · Dermatology Physician in New York

Sources for this page

Verify at the official NPI Registry.