NPIMap

Organization Active NPI

Dermatology Services of Kingston P.C.

  • Procedural Dermatology Physician
  • Kingston, NY
National Provider Identifier
1699713040
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
Legal business name
DERMATOLOGY SERVICES OF KINGSTON P.C.
Practice address
368 Broadway
Kingston, NY 12401-5144
Phone
(845) 338-7472
Fax
(845) 331-4191
NPI assigned
Jun 4, 2006
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Dr. Marie-Louise T Johnson, M.D. PHD
Title
M.D.
Phone
(845) 338-7472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X Primary

Addresses

Primary practice location

368 Broadway
Kingston, NY 12401-5144

Mailing address

368 Broadway, Suite 202
Kingston, NY 12401-5144
Phone (845) 338-7472

National Provider Directory

National Provider Directory

Locations

368 Broadway
Ste 104
Kingston, NY 12401
Phone (845) 338-7472

368 Broadway
Ste 105
Kingston, NY 12401
Phone (845) 334-8635

368 Broadway
Ste 202
Kingston, NY 12401
Phone (845) 338-7472

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1699713040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 BROADWAY, SUITE 202",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015144",
            "telephone_number": "845-338-7472",
            "fax_number": "845-331-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 BROADWAY",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015144",
            "telephone_number": "845-338-7472",
            "fax_number": "845-331-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SERVICES OF KINGSTON P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARIE-LOUISE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "845-338-7472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D. PHD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.