Organization
ISLAND DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD HARLAN FALCON MD (PRESIDENT)
(516) 432-0011
Entity
Organization
Contact information
Practice address
604 E PARK AVE, LONG BEACH, NY 11561-2505
(516) 432-0011
(516) 432-1686
Mailing address
604 E PARK AVE, LONG BEACH, NY 11561-2505
(516) 432-0011
(516) 432-1686
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01453341
—
NY
01
—
14478
AETNA,USHEALTHCARE
—
01
—
2200149
GHI
—
01
—
373723
AMERIHEALTH
—
01
—
7374
VYTRA
—
01
—
W23131
BLUE CROSS/BLUE SHIELD
—
Enumeration date
05/09/2006
Last updated
07/05/2011
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