Provider Demographics
NPI:1225122682
Name:DERMATOLOGIC SURGERY CENTER LLC
Entity Type:Organization
Organization Name:DERMATOLOGIC SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FINZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-7375
Mailing Address - Street 1:7701 GREENBELT RD
Mailing Address - Street 2:504
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2037
Mailing Address - Country:US
Mailing Address - Phone:301-345-7375
Mailing Address - Fax:301-345-0109
Practice Address - Street 1:7701 GREENBELT RD
Practice Address - Street 2:504
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2037
Practice Address - Country:US
Practice Address - Phone:301-345-7375
Practice Address - Fax:301-345-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040882261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE86765Medicare UPIN
MDA00020Medicare PIN