Provider Demographics
NPI:1194383372
Name:CLARITY ACNE AND AESTHETICS LLC
Entity Type:Organization
Organization Name:CLARITY ACNE AND AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:757-567-6099
Mailing Address - Street 1:3345 BRIDGE RD STE 900
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1848
Mailing Address - Country:US
Mailing Address - Phone:757-567-6099
Mailing Address - Fax:757-977-1070
Practice Address - Street 1:3345 BRIDGE RD STE 900
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1848
Practice Address - Country:US
Practice Address - Phone:757-567-6099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty