NPIMap

Organization Active NPI

Great Neck Dermatology, P.C.

  • Specialist
  • Great Neck, NY
National Provider Identifier
1922054980
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
103820 Issued in GA
Legal business name
GREAT NECK DERMATOLOGY, P.C.
Practice address
233 E Shore Rd
Suite 102
Great Neck, NY 11023-2433
Phone
(516) 773-4500
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Authorized official

Name
Mrs. Barbara Kaczor
Title
Office Manager
Phone
(516) 773-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 103820 GA Primary

Addresses

Primary practice location

233 E Shore Rd
Suite 102
Great Neck, NY 11023-2433

Mailing address

233 E Shore Rd
Suite 102
Great Neck, NY 11023-2433
Phone (516) 773-4500

National Provider Directory

National Provider Directory

Locations

233 E Shore Rd
Ste 102
Great Neck, NY 11023
Phone (516) 733-4500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1922054980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E SHORE RD",
            "address_2": "SUITE 102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232433",
            "telephone_number": "516-773-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E SHORE RD",
            "address_2": "SUITE 102",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232433",
            "telephone_number": "516-773-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT NECK DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "KACZOR",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-773-4500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "103820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.