Organization Name: | LONG ISLAND SKIN CANCER AND DERMATOLOGIC SURGERY, PC |
NPI Number: | 1689677197 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTHONY L. WONG (SECRETARY/TREASURER) |
Mailing Address: | 994 W Jericho Tpke Ste 103 Smithtown |
State: | NY US |
Postal Code: | 117873211 |
Phone Number: | 6318646647 |
Fax Number: | 6318646001 |
NPI Enumeration Date: | 05/30/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 226570 |
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. |