Organization
PROCEDURAL DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE VERGILIS-KALNER MD (PRESIDENT)
(917) 804-4553
Entity
Organization
Contact information
Practice address
4925 BROADWAY, NEW YORK, NY 10034-3101
(718) 255-7546
(917) 975-6272
Mailing address
262 CENTRAL PARK W STE 1D, NEW YORK, NY 10024-3512
(718) 255-7546
(917) 975-6272
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
12/11/2023
Last updated
02/28/2024
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