Individual
AHUVA CICES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5 E 98TH ST FL 5, NEW YORK, NY 10029-6501
(212) 241-9728
Mailing address
5 E 98TH ST FL 5, NEW YORK, NY 10029-6501
(212) 241-9728
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
295295
NY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2017
Last updated
04/09/2026
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