METHODIST OUTRACH LAB NPI 1205912813

NPI Information

  • NPI: 1205912813
  • Provider Name: METHODIST OUTRACH LAB
  • Classification: Dermatology - 207NI0002X
  • Specialization: Clinical & Laboratory Dermatological Immunology
  • Entity Type: Organization
  • Address: 506 6TH ST
    BROOKLYN, NY
    ZIP 11215
  • Phone: (718) 780-3016

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NPI Details

METHODIST OUTRACH LAB is a clinical and laboratory dermatological immunology dermatology in Brooklyn, NY. The provider is a dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases. METHODIST OUTRACH LAB NPI is 1205912813. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

506 6TH ST
BROOKLYN, NY
ZIP 11215-609
Phone: (718) 780-3016

The provider's authorized official is Rabia Mir .
The authorized official title is Director and has the following contact phone number (718) 780-3016.

The enumeration date for this NPI number is 10/27/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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