Provider Demographics
NPI:1316645161
Name:DERMATOLOGY CONSULTING OF WESTCHESTER, PLLC
Entity type:Organization
Organization Name:DERMATOLOGY CONSULTING OF WESTCHESTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOESPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERATORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-584-2687
Mailing Address - Street 1:435 WYNNEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-2319
Mailing Address - Country:US
Mailing Address - Phone:914-584-2687
Mailing Address - Fax:
Practice Address - Street 1:688 WHITE PLAINS RD STE 221
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5015
Practice Address - Country:US
Practice Address - Phone:914-725-8688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty