Provider Demographics
NPI:1831493915
Name:NINA C. DERMATOLOGY P.C.
Entity Type:Organization
Organization Name:NINA C. DERMATOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DERMATOLOGY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-980-9292
Mailing Address - Street 1:561 10TH AVE
Mailing Address - Street 2:SUITE 46D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:561 10TH AVE
Practice Address - Street 2:SUITE 46D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-3033
Practice Address - Country:US
Practice Address - Phone:212-980-9292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty