Active NPI
Rose Dermatology PC
- Dermatology Physician
- Astoria, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 243252
- Legal business name
- ROSE DERMATOLOGY PC
- Practice address
- 3074 31St St
1A
Astoria, NY 11102-1857 - Phone
- (718) 728-3376
- NPI assigned
- Sep 21, 2011
- Last updated
- Oct 28, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lilly-Rose Paraskevas, MD
- Title
- Ceo
- Phone
- (917) 673-4159
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 243252 | NY | Primary |
Addresses
Primary practice location
3074 31St St
1A
Astoria, NY 11102-1857
Mailing address
3074 31St St
1A
Astoria, NY 11102-1857
Phone (718) 728-3376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Rose Dermatology PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dermatology Physician
- New York, NY
- NPI 1962327882
Locations
3074 31st St
Ste 1A
Astoria, NY 11102
Phone (718) 728-3376
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.
-
- Dermatology Physician
- Astoria, NY
- NPI 1891991147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1382918400000",
"number": "1700169125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3074 31ST ST",
"address_2": "1A",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111021857",
"telephone_number": "718-728-3376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3074 31ST ST",
"address_2": "1A",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111021857",
"telephone_number": "718-728-3376"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROSE DERMATOLOGY PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-21",
"last_updated": "2013-10-28",
"status": "A",
"authorized_official_last_name": "PARASKEVAS",
"authorized_official_first_name": "LILLY-ROSE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "917-673-4159",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "NY",
"license": "243252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.