Organization
OPTIMA DERMATOLOGY LLC
Active
Other names
Advanced Dermatology and Skin Cancer Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BERNAT MD (AUTHORIZED OFFICIAL)
(330) 965-8760
Entity
Organization
Contact information
Practice address
987 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512-4222
(330) 965-8760
(330) 965-9325
Mailing address
111 NEW HAMPSHIRE AVE STE 2, PORTSMOUTH, NH 03801-2864
(802) 909-2053
(330) 965-9325
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
Other
Enumeration date
10/13/2005
Last updated
07/01/2024
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