Provider Demographics
NPI:1437462454
Name:ART OF DERMATOLOGY, LLC
Entity Type:Organization
Organization Name:ART OF DERMATOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ART OF DERMATOLOGY LLC
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:212-488-5599
Mailing Address - Street 1:860 5TH AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5856
Mailing Address - Country:US
Mailing Address - Phone:212-488-5599
Mailing Address - Fax:212-488-5557
Practice Address - Street 1:860 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5856
Practice Address - Country:US
Practice Address - Phone:212-488-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220067-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty