Organization
ADVANCED DERMATOLOGY OF NEW YORK, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE D JAEGER D.O. (OFFICER)
(212) 262-2500
Entity
Organization
Contact information
Practice address
1455 WEST AVE, BRONX, NY 10462-7304
(212) 262-2500
(212) 765-3210
Mailing address
200 CENTRAL PARK S, SUITE 107, NEW YORK, NY 10019-1436
(212) 262-2500
(212) 765-3210
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/13/2012
Last updated
12/08/2014
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