Organization
DERMATOLOGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DECLUE (DIRECTOR, PROVIDER RELATIONS)
(407) 875-2080
Entity
Organization
Contact information
Practice address
1220 LINCOLN WAY, SUITE 101, WHITE OAK, PA 15131
(412) 678-8806
(412) 678-3780
Mailing address
151 SOUTHHALL LN STE 300, MAITLAND, FL 32751-7172
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006337010001
—
PA
01
—
959595
HIGHMARK
PA
Enumeration date
08/09/2005
Last updated
07/21/2022
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