Provider Demographics
NPI:1700051158
Name:NSS DERMATOLOGY PLLC
Entity Type:Organization
Organization Name:NSS DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LIBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-433-4569
Mailing Address - Street 1:150 W 55TH ST FRNT 1G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5586
Mailing Address - Country:US
Mailing Address - Phone:212-991-6490
Mailing Address - Fax:646-349-2493
Practice Address - Street 1:150 W 55TH ST
Practice Address - Street 2:#GF
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5305
Practice Address - Country:US
Practice Address - Phone:212-991-6490
Practice Address - Fax:646-349-2493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211528207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty