Provider Demographics
NPI:1245268275
Name:BARRINGTON PARK DERMATOLOGICAL ASSOCIATES PC
Entity type:Organization
Organization Name:BARRINGTON PARK DERMATOLOGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-383-4420
Mailing Address - Street 1:220 LINDEN OAKS STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2839
Mailing Address - Country:US
Mailing Address - Phone:585-383-4420
Mailing Address - Fax:585-383-4515
Practice Address - Street 1:220 LINDEN OAKS STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2839
Practice Address - Country:US
Practice Address - Phone:585-383-4420
Practice Address - Fax:585-383-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CB2246OtherRAILROAD MEDICARE
NYG0182226590OtherEXCELLUS MANAGED CARE PRO
NYGRP512112001OtherBLUE SHIELD OF WNY GM
NY04924489Medicaid
NYGRP916166001OtherBLUE SHIELD OF WNY GM
=========OtherAETNA PRODUCTS
=========OtherEXCELLUS INDEMNITY PLAN
NY14162AMedicare ID - Type Unspecified