Provider Demographics
NPI:1508866039
Name:CHELSEA DERMATOLOGY AKA VIRGIL HATCHER, M.D., P.C.
Entity Type:Organization
Organization Name:CHELSEA DERMATOLOGY AKA VIRGIL HATCHER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:212-675-4244
Mailing Address - Street 1:420 W 23RD ST
Mailing Address - Street 2:SUITE A-GF
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2172
Mailing Address - Country:US
Mailing Address - Phone:212-675-4244
Mailing Address - Fax:
Practice Address - Street 1:420 W 23RD ST
Practice Address - Street 2:SUITE A-GF
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2172
Practice Address - Country:US
Practice Address - Phone:212-675-4244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138498261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY69A761Medicare ID - Type Unspecified
NYB18658Medicare UPIN