Organization
ACCREDITED DERMATOLOGIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN S. ZUCKERMAN MD (MEDICAL DIRECTOR)
(718) 423-0200
Entity
Organization
Contact information
Practice address
23-83 BELL BLVD, BAYSIDE, NY 11360
(718) 423-0200
Mailing address
23-83 BELL BLVD, BAYSIDE, NY 11360
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
6417
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6417
AMERICAN ASSOCIATION FOR ACCREDITATION OF AMBULATORY FACILITIES, INC.
NY
Enumeration date
03/14/2018
Last updated
03/14/2018
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