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Organization
PARK AVENUE DERMATOLOGY
Active
Organization
PARK AVENUE DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA DICK (OFICE MANAGER)
(718) 981-5040
Entity
Organization
Contact information
Practice address
31 TIOGA ST, STATEN ISLAND, NY 10301
(718) 981-5040
Mailing address
31 TIOGA ST, STATEN ISLAND, NY 10301
(718) 981-5040
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
018032
NY
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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