Dermatology & Advanced Skin Care

Primary specialty

SpecialistTaxonomy code 174400000X

License

D0030058 Issued in MD

Legal business name

DERMATOLOGY & ADVANCED SKIN CARE

Practice address

6021 University Blvd
Suite 390
Ellicott City, MD 21043-6077

Phone

(410) 203-0607

Fax

(410) 203-0677

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Elisa Rusonis

Title

Administrator

Phone

(410) 203-0607

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1992738124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6021 UNIVERSITY BLVD",
            "address_2": "SUITE 390",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436077",
            "telephone_number": "410-203-0607",
            "fax_number": "410-203-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 UNIVERSITY BLVD",
            "address_2": "SUITE 390",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436077",
            "telephone_number": "410-203-0607",
            "fax_number": "410-203-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & ADVANCED SKIN CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "RUSONIS",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-203-0607"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0030058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "553M860F",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mirka Denis
• Robert J Denmark, LCPC
• Ruth Prendergast Dennison-Tedesco, PHD
• Roxanne Depietro-Hartman, OTR/L
• Mitra Derakhshan, DDS MS
• Dermatology & Advanced Skin Care, Inc.
• Helen E. Derossi, LCSW-C
• Chetna Kartik Desai, D.D.S.
• Kartik J Desai, MD
• Rupal R Desai, M.D.

• Specialist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.