Provider Demographics
NPI:1760685689
Name:ANTHONY DEE MD PLLC
Entity Type:Organization
Organization Name:ANTHONY DEE MD PLLC
Other - Org Name:DERMATOLOGIC CENTER FOR EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-759-7759
Mailing Address - Street 1:9276 MAIN ST STE 1A
Mailing Address - Street 2:PO BOX 554
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-0554
Mailing Address - Country:US
Mailing Address - Phone:716-759-7759
Mailing Address - Fax:716-759-1759
Practice Address - Street 1:9276 MAIN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1969
Practice Address - Country:US
Practice Address - Phone:716-759-7759
Practice Address - Fax:716-759-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2141671174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0208Medicare ID - Type Unspecified
NYH82832Medicare UPIN