Organization
ERIC KUSSELUK, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A DEITCHMAN M.D. (OWNER)
(212) 753-6048
Entity
Organization
Contact information
Practice address
635 MADISON AVE FL 3, NEW YORK, NY 10022-1009
(212) 753-6048
Mailing address
635 MADISON AVE FL 3, NEW YORK, NY 10022-1009
(212) 753-6048
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
239183
NY
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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