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Organization

ELEVATE DERMATOLOGY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TAMARA KOSS MD (PRESIDENT)
(917) 575-5306
Entity
Organization

Contact information

Practice address
66 COMMACK RD STE 200, COMMACK, NY 11725-3405
(631) 481-7470
(631) 623-1623
Mailing address
66 COMMACK RD STE 200, COMMACK, NY 11725-3405
(631) 481-7470

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
07/25/2023
Last updated
11/19/2023
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