# RUSSAK DERMATOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487992871
- **Authorized official:** JULIE E RUSSAK MD (OWNER)
- **Authorized official phone:** (212) 684-5964

## Contact information

- **Practice address:** 115 E 57TH ST, 12TH FLOOR, NEW YORK, NY 10022-2049
- **Practice address phone:** (212) 684-5964
- **Mailing address:** 115 E 57TH ST, 12TH FLOOR, NEW YORK, NY 10022-2049
- **Mailing address phone:** (212) 684-5964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 249307-1 | NY | Yes |

## Other

- **Enumeration date:** 01/21/2013
- **Last updated:** 01/21/2013