Organization
AESTHETIC AND SURGICAL DERMATOLOGY OF NEW YORK, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLE HAZAN (PRESIDENT)
(516) 365-2300
Entity
Organization
Contact information
Practice address
3111 NEW HYDE PARK RD, NEW HYDE PARK, NY 11042-1217
(516) 365-2300
Mailing address
3111 NEW HYDE PARK RD, NEW HYDE PARK, NY 11042-1217
(516) 365-2300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
243559
NY
207ND0101X
MOHS-Micrographic Surgery Physician
243559
NY
207NS0135X
Procedural Dermatology Physician
243559
NY
Other
Enumeration date
07/09/2009
Last updated
07/16/2009
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