NPIMap

Organization Active NPI

Dermatologic Procedures of Suffolk County

  • Specialist
  • West Islip, NY
National Provider Identifier
1740655331
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AAAASF CERT # 5763 Issued in NY
Legal business name
DERMATOLOGIC PROCEDURES OF SUFFOLK COUNTY
Practice address
510 Montauk Hwy
West Islip, NY 11795-4422
Phone
(516) 625-6222
NPI assigned
Dec 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Joshua L Fox, M.D.
Title
Medical Director
Phone
(516) 625-6222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X AAAASF CERT # 5763 NY Primary

Addresses

Primary practice location

510 Montauk Hwy
West Islip, NY 11795-4422

Mailing address

510 Montauk Hwy
West Islip, NY 11795-4422
Phone (516) 625-6222

Other identifiers 1

IdentifierTypeStateIssuer
5763OtherNYAMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1740655331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954422",
            "telephone_number": "516-625-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954422",
            "telephone_number": "516-625-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGIC PROCEDURES OF SUFFOLK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-08",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "516-625-6222",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "AAAASF CERT # 5763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY SURGERY FACILITIES, INC.",
            "identifier": "5763",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.