Provider Demographics
NPI:1932359726
Name:BAY HARBOR DERMATOLOGY & COSMETIC CENTER
Entity Type:Organization
Organization Name:BAY HARBOR DERMATOLOGY & COSMETIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPLIK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-403-6100
Mailing Address - Street 1:1045 95TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2108
Mailing Address - Country:US
Mailing Address - Phone:305-403-6100
Mailing Address - Fax:
Practice Address - Street 1:1045 95TH ST STE 300
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2108
Practice Address - Country:US
Practice Address - Phone:305-403-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty