Individual
VITALY TERUSHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 E 69TH ST APT 1C, NEW YORK, NY 10021-5437
(212) 772-3600
Mailing address
205 E 69TH ST APT 1C, NEW YORK, NY 10021-5437
(212) 772-3600
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
25MA09654300
NJ
207N00000X
Dermatology Physician
269373
NY
207N00000X
Dermatology Physician
MD451382
PA
207ND0101X
MOHS-Micrographic Surgery Physician
25MA09654300
NJ
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
269373
NY
Other
Enumeration date
03/20/2010
Last updated
01/02/2022
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