Provider Demographics
NPI:1275309015
Name:DERMATOLOGY SPECIALISTS OF DELAWARE
Entity Type:Organization
Organization Name:DERMATOLOGY SPECIALISTS OF DELAWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-385-3700
Mailing Address - Street 1:1027 46TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5202
Mailing Address - Country:US
Mailing Address - Phone:212-385-3700
Mailing Address - Fax:
Practice Address - Street 1:3411 SILVERSIDE RD STE 107
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4806
Practice Address - Country:US
Practice Address - Phone:302-478-8532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty