Theta Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

THETA DERMATOLOGY PC

Practice address

2508 Western Ave
Altamont, NY 12009-9485

Phone

(518) 690-0177

Fax

(518) 690-0169

NPI assigned

Dec 6, 2017

Last updated

Dec 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Theta S Pattison, MDNPI 1841298510

Title

Director

Phone

(518) 690-0177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Theta S Pattison, MD

  • Dermatology Physician
  • Altamont, NY
  • NPI 1841298510
  Authorized official Same address or phone

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1689189185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 WESTERN AVE",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120099485",
            "telephone_number": "518-690-0177",
            "fax_number": "518-690-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 WESTERN AVE",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120099485",
            "telephone_number": "518-690-0177",
            "fax_number": "518-690-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THETA DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "PATTISON",
        "authorized_official_first_name": "THETA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-690-0177",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "188200",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Schools
• Sarah Slotkin
• Pamela Jean Smith I, OTR
• Mary Spratt, PA
• Tamara A Stewart
• Theta Pattison MD
• Brian J Thornton, PT
• Raj Tuppal, MD
• VA Medical Center
• Nina Vlainich, FNP-BC

• Dermatology Physician in Altamont, NY
• Providers in Altamont, 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 Dec 6, 2017; 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.