Organization Name: | BODIAN DERMATOLOGY GROUP, P.C |
NPI Number: | 1659412104 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ADAM BEN BODIAN (PRESIDENT) |
Mailing Address: | 11 Grace Ave Suite 100 Great Neck |
State: | NY US |
Postal Code: | 110212417 |
Phone Number: | 5164822882 |
Fax Number: | 5164826039 |
NPI Enumeration Date: | 02/09/2007 |
NPI Last Update Date: | 05/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 176289 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |