Organization
COSMETIC SURGERY AND DERM, PLLC
Active
Other names
DermgroupNYC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR TORRES M.D. (MEDICAL DIRECTOR)
(212) 673-5633
Entity
Organization
Contact information
Practice address
117 E 18TH ST, SUITE 1, NEW YORK, NY 10003-2113
(212) 673-5633
Mailing address
117 E 18TH ST, SUITE 1, NEW YORK, NY 10003-2113
(212) 673-5633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018002
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WER941
MEDICAREGROUP
NY
Enumeration date
09/23/2014
Last updated
09/23/2014
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