Organization
UPPER WEST SIDE DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA TRAVIS M.D. (SOLE OWNER)
(212) 769-0069
Entity
Organization
Contact information
Practice address
277 W END AVE APT 1B, NEW YORK, NY 10023-2605
(212) 769-0069
Mailing address
277 W END AVE APT 1B, NEW YORK, NY 10023-2605
(212) 769-0069
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
238877
NY
Other
Enumeration date
05/03/2007
Last updated
12/12/2019
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