Provider Type Icon

DERMATOLOGY & PLASTIC SURGERY OF NORTHERN NEW YORK PC NPI 1598852329


NPI Information

NPI: 1598852329
Provider Name: DERMATOLOGY & PLASTIC SURGERY OF NORTHERN NEW YORK PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
826 WASHINGTON STREET
SUITE 104
WATERTOWN, NY
ZIP 13601
Phone: (315) 786-1500
Get Directions

DERMATOLOGY & PLASTIC SURGERY OF NORTHERN NEW YORK PC is a specialist in Watertown, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY & PLASTIC SURGERY OF NORTHERN NEW YORK PC NPI is 1598852329. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

826 WASHINGTON STREET
SUITE 104
WATERTOWN, NY
ZIP 13601-065
Phone: (315) 786-1500

The provider's authorized official is Barbara Licznerski .
The authorized official title is President and has the following contact phone number (315) 786-1500.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 2/18/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistNEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1AA0167OTHERNEW YORKGROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.