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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