SKG Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKG DERMATOLOGY PLLC

Practice address

1940 Deer Park Ave
#145
Deer Park, NY 11729-3333

Phone

(734) 282-2500

NPI assigned

Mar 3, 2014

Last updated

Mar 3, 2014By 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

Steven Kenneth Grekin, DONPI 1407836877

Title

Ceo

Phone

(734) 282-2500

Specialties & licenses 1

Addresses

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.

• Steven Kenneth Grekin, D.O.

  • Dermatology Physician
  • Warren, MI
  • NPI 1407836877
  Authorized official Same address or phone

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1760807515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13450 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883671",
            "telephone_number": "586-759-5525",
            "fax_number": "586-759-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 DEER PARK AVE",
            "address_2": "#145",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293333",
            "telephone_number": "734-282-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKG DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "GREKIN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-282-2500",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Simeon, LAC
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• Ellen D Slattery
• Debra A. Sluter, LMT
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• Dawn Marie Smith, LPN
• Melanie Smith

• Dermatology Physician in Deer Park, NY
• Providers in Deer Park, 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 Mar 3, 2014; 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.