Organization
ADVANCED DERMATOLOGY OF NEW YORK PC
Active
Organization
ADVANCED DERMATOLOGY OF NEW YORK PC
Active
Other names
Advanced Dermatology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE D JAEGER D.O. (OFFICER)
(212) 262-2500
Entity
Organization
Contact information
Practice address
2100 BARTOW AVE, STE 211, BRONX, NY 10475-4614
(718) 865-0515
(212) 246-0890
Mailing address
200 CENTRAL PARK SOUTH, STE 107, NEW YORK, NY 10019
(212) 262-2500
(212) 246-0890
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518964923
NPI
—
Enumeration date
06/30/2005
Last updated
07/21/2022
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