Dermatology West 57TH Services PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

136938 Issued in NY

Legal business name

DERMATOLOGY WEST 57TH SERVICES PC

Practice address

315 W 57TH St
Suite 405
New York, NY 10019-3158

Phone

(212) 245-8123

Fax

(212) 765-0601

NPI assigned

Jan 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Heller, M.D.

Title

President

Phone

(212) 245-8123

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1891026209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 57TH ST",
            "address_2": "SUITE 405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193158",
            "telephone_number": "212-245-8123",
            "fax_number": "212-765-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 57TH ST",
            "address_2": "SUITE 405",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193158",
            "telephone_number": "212-245-8123",
            "fax_number": "212-765-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY WEST 57TH SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-245-8123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "136938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in New York, NY
• Providers in New York, 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 Jan 25, 2010; 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.