Organization
GOLD COAST DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARISSE L MCCALL DO (PRESIDENT)
(631) 467-4653
Entity
Organization
Contact information
Practice address
149 COMMACK RD STE B, COMMACK, NY 11725-3459
(631) 467-4653
Mailing address
149 COMMACK RD STE B, COMMACK, NY 11725-3459
(631) 467-4653
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03918898
—
NY
Enumeration date
05/25/2021
Last updated
08/25/2021
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