MIMI G BANSAL, MD (NPI# 1003978669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003978669 |
| Entity Type | Organization |
| Organization Name | MIMI G BANSAL, MD |
| Practice Address |
2001 Marcus Ave Suite N218 Lake Success NY 11042 |
| Mailing Address |
2 Polo Dr Old Westbury NY 11568-1043 |
| Practice Telephone | 5163522700 |
| Practice Fax Number | 5164376904 |
| Mailing Telephone | 5163522700 |
| Mailing Fax Number | 5164376904 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MIMI G BANSAL (OWNER) |
| Authorized Official Telephone | 5163522700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
2122661 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
2001 MARCUS AVE SUITE N218 |
| City | LAKE SUCCESS |
| State | NY |
| Zip Code | 11042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174520621 | Michael M Ziegelbaum | Urology | 2001 Marcus Ave, Suite N-214, Lake Success, NY 11042-1011 | 2005-06-30 |
| 1326311820 | Allergy and Asthma Care of Nassau and Suffolk, Pllc | Allergy & Immunology | 2001 Marcus Ave, Suite N220, Lake Success, NY 11042 | 2012-02-14 |
| 1689817439 | Ameeta Ahuja Walia | Internal Medicine | 2001 Marcus Ave, Suite N 210, Lake Success, NY 11042-2061 | 2009-04-09 |
| 1366651846 | Stacie K Castle | Dietitian, Registered | 2001 Marcus Ave, Suite N220, Lake Success, NY 11042 | 2007-05-22 |
| 1083762751 | Karen M Kostroff | Surgery | 2001 Marcus Ave, Suite W270, Lake Success, NY 11042 | 2007-01-08 |
| 1811085988 | Frank A. Tomao, Md,john S.marino,md,brian T.mcnelis,md,pc | Internal Medicine | 2001 Marcus Ave, Suite S265, Lake Success, NY 11042-1035 | 2006-10-11 |
| 1255426862 | Gail Phillips | Radiology | 2001 Marcus Ave, Lake Success, NY 11042 | 2006-10-03 |
| 1285728709 | Sheila Kumari-subaiya | Radiology | 2001 Marcus Ave, Lake Success, NY 11042 | 2006-10-02 |
| 1164530309 | Completecare Cardiology Pllc | Internal Medicine | 2001 Marcus Ave, Suite W285, Lake Success, NY 11042 | 2006-08-28 |
| 1528076528 | New York Spine Specialists LLP | Orthopaedic Surgery | 2001 Marcus Ave, Ste 170 West New York Spine Specialists LLP, Lake Success, NY 11042-1035 | 2006-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871260 | Advanced Cardiovascular Diagnostics, Pllc | Internal Medicine | 410 Lakeville Road Suite 209, New Hyde Park, NY 11042 | 2020-11-02 |
| 1568093771 | Global Slp Ot Pt & Psychological Services, Pllc | Physical Therapist | 1979 Marcus Avenue - Suite 204, Attn: Jon Polish, Lake Success, NY 11042 | 2020-01-28 |
| 1730745761 | Miriam Korbman | Psychologist | 2001 Marcus Ave Suite E128, Lake Success, NY 11042 | 2019-05-15 |
| 1306402409 | Swachi Jain | Student in an Organized Health Care Education/Training Program | Northwell Health Pathology, 6 - Ohio Drive, Suite 202, Lake Success, NY 11042 | 2019-05-14 |
| 1215407432 | Samara Carly Badash | Physical Therapist | Brookville Center for Children's Services, 1983 Marcus Avenue, Suite E100, New Hyde Park, NY 11042 | 2018-11-30 |
| 1720578578 | Nidhi Kataria | Student in an Organized Health Care Education/Training Program | Department of Pathology and Laboratory Medicine, Northw, 6 Ohio Drive, Suite 202, Lake Success, NY 11042 | 2018-05-17 |
| 1558870162 | Rosemary Elizabeth Fine | Nurse Practitioner | 1999 Marcus Ave Ste 306, New Hyde Park, NY 11042 | 2017-09-26 |
| 1255861159 | Nicole Renee Cohen | Speech-Language Pathologist | 1893 Marcus Ave, C118, New Hyde Park, NY 11042 | 2017-06-14 |
| 1366807943 | Molly Rubinoff | Nurse Practitioner | 1215 One Hollow Lane, #301, New Hyde Park, NY 11042 | 2015-12-23 |
| 1255701959 | Prohealth Dental Pllc | Dentist | 1 Pro Health Plz, Suite 115, New Hyde Park, NY 11042 | 2015-10-07 |
| Find all providers in zip 11042 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835364 | Skin & Aesthetic Surgery of Manhattan | Dermatology | 120 E 56th St # 1500, New York, NY 10022-3607 | 2020-09-14 |
| 1710443015 | Robert Paul Cipolla | Dermatology | 48 Cordelia Ave, Staten Island, NY 10309-3434 | 2019-02-12 |
| 1861889552 | Miriam R Lieberman | Dermatology | 2003 Avenue J Ste 1c, Brooklyn, NY 11210-3605 | 2015-04-20 |
| 1417206459 | Brett Marsh Dolgin | Dermatology | 255 Great Neck Rd Apt Ph15, Great Neck, NY 11021-3358 | 2012-09-06 |
| 1700149077 | Meghan Anne Feely | Dermatology | 300 E 75th St, 18l, New York, NY 10021-0216 | 2012-06-20 |
| 1487936308 | Union Square Laser Dermatology | Dermatology | 19 Union Sq W Fl 5, New York, NY 10003-3304 | 2011-09-16 |
| 1073764809 | William Jay Greenberg | Dermatology | 301 E 81st St, New York, NY 10028-4033 | 2008-10-10 |
| 1073780540 | Lewis M. Dubroff, M.d.,p.c. | Dermatology | 475 Irving Ave Ste 314, Syracuse, NY 13210-1528 | 2008-05-13 |
| 1992983456 | Jared Jagdeo | Dermatology | 450 Clarkson Ave Fl 8, Brooklyn, NY 11203-2012 | 2008-02-07 |
| 1437339447 | Mary Louise Lenahan | Dermatology | 9388 Transit Rd, East Amherst, NY 14051-1494 | 2007-11-07 |
| Find all providers with the same taxonomy | ||||
| City | LAKE SUCCESS |
| Zip Code | 11042 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.