BRUMMITTE DALE WILSON (NPI# 1245237288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245237288 |
| Entity Type | Individual |
| Full Name | BRUMMITTE DALE WILSON |
| Credential | M.D. |
| Practice Address |
17 Long Ave Suite 200 Hamburg NY 14075-6200 |
| Practice Telephone | 7166482770 |
| Practice Fax Number | 7166464642 |
| Mailing Telephone | 7166482770 |
| Mailing Fax Number | 7166464642 |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2013-08-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
134469 | NY | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
1344691 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
17 LONG AVE SUITE 200 |
| City | HAMBURG |
| State | NY |
| Zip Code | 14075-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699772913 | Cornelie M. Jones | Dermatology | 17 Long Ave, Suites 200 & 201, Hamburg, NY 14075-6200 | 2005-07-01 |
| 1942550017 | Melinda Sue Haas | Registered Nurse | 17 Long Ave, Suite Number 110, Hamburg, NY 14075-6200 | 2012-09-14 |
| 1518928456 | Joan G Calkins | Pediatrics | 17 Long Ave, Ste 110, Hamburg, NY 14075 | 2006-03-30 |
| 1215998521 | Evan Calkins | Internal Medicine | 17 Long Ave, Ste 110, Hamburg, NY 14075 | 2006-03-29 |
| 1578561247 | Peter Santalucia | Dermatology | 17 Long Ave, Suite 200, Hamburg, NY 14075-6200 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538781281 | Devan Fischer | Student in an Organized Health Care Education/Training Program | 6490-17 Taylor Woods Road, Hamburg, NY 14075 | 2020-05-15 |
| 1417590746 | Jackson Mar | Counselor | 140 Pine St., Hamburg, NY 14075 | 2019-10-18 |
| 1831666122 | Andrea Lynn Baron | Physician Assistant | 5022 Morgan Parkway, Hamburg, NY 14075 | 2018-10-25 |
| 1164905584 | Michael Grundtisch | Physical Therapist | 5284 Briercliff Drive, Hamburg, NY 14075 | 2018-09-11 |
| 1629571187 | Dawn Rydzynski | Counselor | 140 Pin St, Hamburg, NY 14075 | 2018-03-12 |
| 1760990873 | Buffalo Orthopaedic Group, LLP | Orthopaedic Surgery | 4901 Camp Rd. Suite 100, Buffalo Orthopaedic Group, LLP, Hamburg, NY 14075 | 2018-01-11 |
| 1821500562 | Theresa M Tripi | Counselor | 140 Pin Street, Hamburg, NY 14075 | 2017-11-03 |
| 1831548841 | Mary Coble | Student in an Organized Health Care Education/Training Program | 6490-17 Taylor Road, Hamburg, NY 14075 | 2016-06-09 |
| 1700287737 | Jessica Schreiner | Occupational Therapist | 6490-17 Taylor Rd, Hamburg, NY 14075 | 2014-09-09 |
| 1235576976 | Christina Lowman | Dietitian, Registered | 4535 Southwestern Blvd Suite 804a, Southtowns Medical and Professional Park, Hamburg, NY 14075 | 2013-06-03 |
| Find all providers in zip 14075 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598225260 | Dermatology Laser and Surgery of Carnegie Hill Pllc | Dermatology | 1095 Park Ave Ste 1a, New York, NY 10128-1154 | 2019-03-20 |
| 1245651827 | Complete Skin & Laser Surgery PC | Dermatology | 225 E 64th St Fl 2, New York, NY 10065-6690 | 2013-12-26 |
| 1598043432 | Marmur Dermatology and Cardiology, Pllc | Dermatology | 12 E 87th St Suite 1a, New York, NY 10128-0501 | 2011-07-26 |
| 1427343391 | Skin Cancer and Aesthetic Surgery, P.C. | Dermatology | 2727 Ocean Pkwy, Suite L1, Brooklyn, NY 11235-7857 | 2011-06-18 |
| 1174814735 | Reason Wilken | Dermatology | 1991 Marcus Ave Ste 300, North New Hyde Park, NY 11042-2058 | 2011-04-29 |
| 1760658033 | Advanced Dermatology PC | Dermatology | 165 Roslyn Rd, Roslyn Heights, NY 11577-1315 | 2008-05-06 |
| 1255535993 | Weill Medical College of Cornell University | Dermatology | 1305 York Ave., 9th Floor, New York, NY 10021-4870 | 2007-06-14 |
| 1336291657 | Michael Jonathan Albom | Dermatology | 33 E 70th St, 1f, New York, NY 10021-4941 | 2007-01-17 |
| 1386719425 | Ronald R Brancaccio Md & Peter Saitta Do PC | Dermatology | 7901 4th Avenue, Apt A20, Brooklyn, NY 11209-3957 | 2006-11-22 |
| 1255415113 | The Center for Dermatologic Surgery of Monroe | Dermatology | 503 State Route 208, Monroe, NY 10950-1619 | 2006-10-25 |
| Find all providers with the same taxonomy | ||||
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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.