Provider Demographics
NPI:1992785117
Name:ORBUCH, BRAND DERMATOLOGY ASSOCIATES LLP
Entity type:Organization
Organization Name:ORBUCH, BRAND DERMATOLOGY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:ORBUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-731-6505
Mailing Address - Street 1:4277 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5709
Mailing Address - Country:US
Mailing Address - Phone:516-731-6505
Mailing Address - Fax:516-735-8746
Practice Address - Street 1:4277 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 206
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5709
Practice Address - Country:US
Practice Address - Phone:516-731-6505
Practice Address - Fax:516-735-8746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric DermatologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW1L011Medicare ID - Type Unspecified