Organization
EMPIRE DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA H MADDEN (PRACTICE MANAGER)
(315) 935-9247
Entity
Organization
Contact information
Practice address
5823 WIDEWATERS PKWY, SUITE 4, EAST SYRACUSE, NY 13057-3084
(315) 500-7546
(888) 454-8316
Mailing address
5823 WIDEWATERS PKWY, SUITE 4, EAST SYRACUSE, NY 13057-3084
(315) 500-7546
(315) 378-4210
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
282257
NY
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
09/29/2016
Last updated
03/16/2023
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