Organization
57 WEST DERMATOLOGY LLC
Active
Organization
57 WEST DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN TODD GLASS M.D. (OWNER)
(516) 297-2691
Entity
Organization
Contact information
Practice address
57 W 57TH ST, SUITE 1109, NEW YORK, NY 10019-2802
(516) 297-2691
Mailing address
57 W 57TH ST, SUITE 1109, NEW YORK, NY 10019-2802
(516) 297-2691
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
196509
NY
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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