Organization
RADIANT SKIN DERMATOLOGY AND LASER,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEBOLA OLUFUNMI DELE-MICHAEL MD (OWNER)
(212) 229-0007
Entity
Organization
Contact information
Practice address
207 W 115TH ST LOWR LEVEL, NEW YORK, NY 10026-2965
(212) 229-0007
(347) 274-8349
Mailing address
234 CENTRAL PARK W, NEW YORK, NY 10024-6003
(212) 229-0007
(212) 202-6350
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
256265
NY
Other
Enumeration date
12/31/2012
Last updated
03/04/2024
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