Individual
DR. DARREN KEITH MOLLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
175 JERICHO TPKE, SUITE 320, SYOSSET, NY 11791-4532
(516) 921-6780
Mailing address
175 JERICHO TPKE, SUITE 320, SYOSSET, NY 11791-4532
(516) 921-6780
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
217820
NY
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
217820-4
NY
207NP0225X
Pediatric Dermatology Physician
217820
NY
207NS0135X
Procedural Dermatology Physician
217820
NY
Other
Enumeration date
11/30/2005
Last updated
10/02/2007
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