Organization
COMMUNITY MEDICAL &DERMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE D JAEGER D.O. (PRESIDENT)
(212) 262-2500
Entity
Organization
Contact information
Practice address
200 CENTRAL PARK S, SUITE 107, NEW YORK, NY 10019-1436
(212) 262-2500
(212) 246-0890
Mailing address
291 E 149TH ST, BRONX, NY 10451-5601
(718) 742-6014
(212) 246-0890
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02370854
—
NY
Enumeration date
10/26/2005
Last updated
08/22/2020
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