Ny Mohs Laser Dermatology

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

147719-1 Issued in NY

Legal business name

NY MOHS LASER DERMATOLOGY

Practice address

345 E 37TH St
#209
New York, NY 10016-3256

Phone

(646) 490-7387

Fax

(212) 686-5842

NPI assigned

Mar 30, 2011

Last updated

Dec 20, 2012By 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

Dr. Vicki Joy Levine, MD

Title

Medical Director

Phone

(646) 490-7387

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1942599972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 E 37TH ST",
            "address_2": "#209",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163256",
            "telephone_number": "646-490-7387",
            "fax_number": "212-686-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E 37TH ST",
            "address_2": "#209",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163256",
            "telephone_number": "646-490-7387",
            "fax_number": "212-686-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY MOHS LASER DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "646-490-7387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "147719-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• MOHS-Micrographic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.