NPIMap

Organization Active NPI

Lighthouse Dermatology, P.C.

  • Procedural Dermatology Physician
  • New York, NY
National Provider Identifier
1770765893
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
206357 Issued in NY
Legal business name
LIGHTHOUSE DERMATOLOGY, P.C.
Practice address
110 E 59TH St
Suite 10D
New York, NY 10022-1304
Phone
(212) 583-2920
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Dr. Soren Matthew White, M.D.
Title
Owner/President
Phone
(212) 396-3688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X 206357 NY Primary

Addresses

Primary practice location

110 E 59TH St
Suite 10D
New York, NY 10022-1304

Mailing address

110 E 59TH St
Suite 10D
New York, NY 10022-1304
Phone (212) 583-2920

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1770765893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 59TH ST",
            "address_2": "SUITE 10D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221304",
            "telephone_number": "212-583-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 59TH ST",
            "address_2": "SUITE 10D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221304",
            "telephone_number": "212-583-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SOREN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "212-396-3688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "206357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.