Organization
UNIVERSITY DERMATOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN J HAIBACH (CFO)
(585) 756-4010
Entity
Organization
Contact information
Practice address
229 SUMMIT ST STE 7, BATAVIA, NY 14020-1645
(585) 344-4811
(585) 344-4812
Mailing address
229 SUMMIT ST STE 7, BATAVIA, NY 14020-1645
(585) 344-4811
(585) 344-4812
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0183268190
BLUE CHOICE GROUP NUMBER
NY
Enumeration date
11/28/2006
Last updated
04/01/2011
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