Organization
UPPER WEST SIDE DERMATOLOGY INC
Active
Organization
UPPER WEST SIDE DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA TRAVIS MD (OWNER)
(212) 769-0069
Entity
Organization
Contact information
Practice address
211 CENTRAL PARK W, SUITE 1F, NEW YORK, NY 10024-6020
(212) 769-0069
Mailing address
211 CENTRAL PARK W, SUITE 1F, NEW YORK, NY 10024-6020
(212) 769-0069
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
238877
NY
Other
Enumeration date
07/03/2008
Last updated
04/27/2010
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