Organization
1091 SOUTHERN BLVD DERMATOLOGY PLLC
Active
Organization
1091 SOUTHERN BLVD DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY SANCHEZ (OFFICE MANAGER)
(347) 642-9802
Entity
Organization
Contact information
Practice address
1091 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 401-7000
(917) 473-7878
Mailing address
4037 74TH ST, ELMHURST, NY 11373-5603
(347) 642-9802
(347) 642-9852
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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