Provider Demographics
NPI:1417047952
Name:PARISER DERMATOLOGY SPECIALISTS LTD
Entity Type:Organization
Organization Name:PARISER DERMATOLOGY SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-627-5929
Mailing Address - Street 1:6160 KEMPSVILLE CIR
Mailing Address - Street 2:SUITE 200 A
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3933
Mailing Address - Country:US
Mailing Address - Phone:757-622-6315
Mailing Address - Fax:757-625-6940
Practice Address - Street 1:6160 KEMPSVILLE CIR
Practice Address - Street 2:SUITE 200 A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3933
Practice Address - Country:US
Practice Address - Phone:757-622-6315
Practice Address - Fax:757-625-6940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207N00000X
VA0101261850207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC00705Medicare UPIN
VAC00705Medicare UPIN