Mobile Dermatology Care PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MOBILE DERMATOLOGY CARE PLLC

Practice address

144 Standart Ave
Auburn, NY 13021-1508

Phone

(877) 345-5300

NPI assigned

Jun 26, 2019

Last updated

Mar 26, 2024By 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

Jeffrey Queen

Title

Authorized Official

Phone

(561) 314-2000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1770144123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STANDART AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211508",
            "telephone_number": "877-345-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DERMATOLOGY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirwan Mirza, MD
• Mia Mitchell
• David Allen Mizro, PA
• Elizabeth Mizro, MS, ANP
• Kelley A Mizro
• Faizo Mohamed
• Aroob Moin, DPM
• Andrea Molloy, CCC-SLP
• Rosemarie Montague
• Patrick Ernest Montgomery, RPH

• Dermatology Physician in Auburn, NY
• Providers in Auburn, 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 26, 2024; 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.