Organization
SKIN DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WILLIAMS (BILLER)
(407) 982-4876
Entity
Organization
Contact information
Practice address
5030 BROADWAY STE 342, NEW YORK, NY 10034-1609
(407) 982-4876
Mailing address
5030 BROADWAY STE 342, NEW YORK, NY 10034-1609
(407) 982-4876
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/12/2024
Last updated
08/25/2025
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