Organization
CHILDREN'S SKIN AND LASER, PC
Active
Other names
Brooklyn Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOURAB PATRICK CHOUDHURY DO (PRESIDENT)
(718) 797-5504
Entity
Organization
Contact information
Practice address
440 ATLANTIC AVE, GROUND FLOOR, BROOKLYN, NY 11217-2143
(718) 797-5504
(718) 797-5645
Mailing address
440 ATLANTIC AVE, GROUND FLOOR, BROOKLYN, NY 11217-2143
(718) 797-5504
(718) 797-5645
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
226018
NY
207NP0225X
Pediatric Dermatology Physician
Primary
226018
NY
207NS0135X
Procedural Dermatology Physician
226018
NY
Other
Enumeration date
01/16/2008
Last updated
11/01/2016
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