Provider Demographics
NPI:1669205456
Name:DERMATOLOGY CIRCLE PLLC
Entity type:Organization
Organization Name:DERMATOLOGY CIRCLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIKTORYIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZLOUSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-602-4776
Mailing Address - Street 1:801 MADISON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5930
Mailing Address - Country:US
Mailing Address - Phone:914-602-4776
Mailing Address - Fax:646-449-0713
Practice Address - Street 1:801 MADISON AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5930
Practice Address - Country:US
Practice Address - Phone:914-602-4776
Practice Address - Fax:646-449-0713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty