Provider Demographics
NPI:1699523431
Name:CONCIERGE DERMATOLOGY PLLC
Entity type:Organization
Organization Name:CONCIERGE DERMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-973-3376
Mailing Address - Street 1:6274 LINTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6508
Mailing Address - Country:US
Mailing Address - Phone:561-973-3376
Mailing Address - Fax:561-769-2584
Practice Address - Street 1:6274 LINTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6508
Practice Address - Country:US
Practice Address - Phone:561-973-3376
Practice Address - Fax:561-769-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty