Organization
ADVANCED DERMATOLOGY OF COOP CITY PC
Active
Other names
Advanced Dermatology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE D JAEGER D.O (MEDICAL DIRECTOR)
(212) 262-2500
Entity
Organization
Contact information
Practice address
2100 BARTOW AVE, SUITE 211, BRONX, NY 10475-4614
(718) 671-1000
(212) 765-3210
Mailing address
200 CENTRAL PARK S, SUITE 107, NEW YORK, NY 10019-1436
(212) 262-2500
(212) 765-3210
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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