Organization
PREMIER DERMATOLOGY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARKADY KALYUZHNY (PRESIDENT)
(917) 804-4553
Entity
Organization
Contact information
Practice address
825 CORAL RIDGE DR, CARDIOVASCULAR SUITES, CORAL SPRINGS, FL 33071-4180
(305) 810-8846
Mailing address
214 AMHERST ST, BROOKLYN, NY 11235-4117
(917) 804-4553
(917) 975-6272
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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