Organization
NY MOHS LASER DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICKI JOY LEVINE MD (MEDICAL DIRECTOR)
(646) 490-7387
Entity
Organization
Contact information
Practice address
345 E 37TH ST, #209, NEW YORK, NY 10016-3256
(646) 490-7387
(212) 686-5842
Mailing address
345 E 37TH ST, #209, NEW YORK, NY 10016-3256
(646) 490-7387
(212) 686-5842
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
147719-1
NY
Other
Enumeration date
03/30/2011
Last updated
12/20/2012
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