Organization
21ST CENTURY DERMATOLOGY, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA DIAZ (BILLING MANAGER)
(646) 576-5688
Entity
Organization
Contact information
Practice address
133 E 58TH ST, SUITE 502, NEW YORK, NY 10022-1236
(212) 644-4440
(212) 644-4447
Mailing address
133 E 58TH ST, SUITE 502, NEW YORK, NY 10022-1236
(212) 644-4440
(212) 644-4447
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
231240
NY
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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