Organization
AESTHETIC AND SURGICAL DERMATOLOGY OF NEW YORK, P.C.
Active
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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