Organization
CHILDREN'S SKIN AND LASER, PC
Active
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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