Provider Demographics
NPI:1710710900
Name:AR DERMATOLOGY PC
Entity type:Organization
Organization Name:AR DERMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IZABELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RESZKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-759-8449
Mailing Address - Street 1:1112 PARK AVE # 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1235
Mailing Address - Country:US
Mailing Address - Phone:646-759-8449
Mailing Address - Fax:718-577-5769
Practice Address - Street 1:1112 PARK AVE # 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1235
Practice Address - Country:US
Practice Address - Phone:646-759-8449
Practice Address - Fax:718-577-5769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty