BODIAN DERMATOLOGY GROUP, P.C (NPI# 1659412104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659412104 |
| Entity Type | Organization |
| Organization Name | BODIAN DERMATOLOGY GROUP, P.C |
| Practice Address |
11 Grace Ave Suite 100 Great Neck NY 11021-2417 |
| Practice Telephone | 5164822882 |
| Practice Fax Number | 5164826039 |
| Mailing Telephone | 5164822882 |
| Mailing Fax Number | 5164826039 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2008-05-29 |
| Authorized Official Name | DR. ADAM BEN BODIAN II (PRESIDENT) |
| Authorized Official Telephone | 5164822882 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 176289 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | RAILROAD MEDICARE | CN7593 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | BODIAN DERMATOLOGY GROUP, P.C. | 11 Grace Ave, Great Neck, New York 11021 |
| Street Address |
11 GRACE AVE SUITE 100 |
| City | GREAT NECK |
| State | NY |
| Zip Code | 11021-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952391914 | David Alan Schwartz | Dentist | 11 Grace Ave, Suite 101, Great Neck, NY 11021-2417 | 2005-10-21 |
| 1194172890 | Comprehensive Medical Assist P.C. | Physician Assistant | 11 Grace Ave, Suite 204, Great Neck, NY 11021-2446 | 2016-05-23 |
| 1316283658 | Ak Audiology Care PC | Audiologist | 11 Grace Ave, Suite 106, Great Neck, NY 11021-2446 | 2012-12-13 |
| 1114296753 | Psychological Potentials PC | Psychologist | 11 Grace Ave, Ste 300, Great Neck, NY 11021-2446 | 2011-12-28 |
| 1922129402 | Debora Barchilon | Psychiatry & Neurology | 11 Grace Ave, Suite 204, Great Neck, NY 11021-2417 | 2007-04-03 |
| 1518033687 | Adam Ben Bodian | Dermatology | 11 Grace Ave, Suite 100 Bodian Dermatology Group PC, Great Neck, NY 11021 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097927 | Vital Balance Osteopathy, Pllc | Psychiatry & Neurology | 10 Bond Street, Ste 1, #290, Great Neck, NY 11021 | 2020-09-14 |
| 1770131922 | Bond Orthodontics & Dental Care Pllc | Dentist | 12 Bond Street., Suite#c4, Great Neck, NY 11021 | 2019-08-30 |
| 1295393858 | Ctrip.nyc, Inc. | Emergency Response System Companies | 3 Grace Ave, Suite 106, Great Neck, NY 11021 | 2019-05-30 |
| 1366929267 | Vishva Vajra Acupuncture PC | Acupuncturist | 23a Middle Neck Road, Great Neck, NY 11021 | 2018-07-24 |
| 1518457530 | Assured Quality Home Care, Inc. | In Home Supportive Care | 885 Northern Blvd., Greak Neck, NY 11021 | 2018-05-15 |
| 1881183275 | Liat Mindy Brody | Occupational Therapist | 7 Hickory Dr, Great Neck, NY 11021 | 2018-05-01 |
| 1457853707 | Allison Squillace | Social Worker | 7 Bond Suite 1a, Great Neck, NY 11021 | 2018-03-02 |
| 1275042855 | Seolhee Kang | Acupuncturist | 26 Linden Street, Apt 4c, Great Neck, NY 11021 | 2017-09-26 |
| 1346781598 | Sara Dreiblatt | Speech-Language Pathologist | 211-45 46th Road, Queens, NY 11021 | 2017-03-20 |
| 1962853416 | Darron Yelling Do, PC | Surgery | 305 Northen Blvd, 105, Great Neck, NY 11021 | 2016-06-27 |
| Find all providers in zip 11021 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326519083 | Nelida Barrera | Specialist | 9 Northern Blvd, Great Neck, NY 11021-4044 | 2018-12-06 |
| 1558831859 | Wen-ling Lee | Specialist | 1 E Mill Dr Apt 2a, Great Neck, NY 11021-4077 | 2018-11-29 |
| 1386110864 | Rebecca Abigail Soleimani | Specialist | 19 N Clover Dr, Great Neck, NY 11021-1013 | 2018-10-22 |
| 1285114827 | Joshua Hakimian | Specialist | 20 Hicks Ln, Great Neck, NY 11024-1937 | 2018-08-14 |
| 1982191144 | Milko Aminian | Specialist | 11 Woodbourne Rd, Great Neck, NY 11023-1318 | 2018-04-13 |
| 1104367176 | Jessica Lin | Specialist | 4515 Westminster Rd, Great Neck, NY 11020-1050 | 2017-03-10 |
| 1326582610 | Firoozeh Bandanzadeh | Specialist | 45 Ellard Ave, Great Neck, NY 11024-2036 | 2016-12-06 |
| 1851834451 | Allison Unger | Specialist | 14 Stoner Ave, Apartment 3j, Great Neck, NY 11021-2101 | 2016-11-30 |
| 1386190940 | Deborah Namdar | Specialist | 101 Hampshire Rd, Great Neck, NY 11023-1230 | 2016-09-01 |
| 1881064434 | Esther Lebto | Specialist | 10 Devon Rd, Great Neck, NY 11023-2317 | 2015-09-25 |
| Find all providers in GREAT NECK | ||||
| City | GREAT NECK |
| Zip Code | 11021 |
Please comment or provide details below to improve the information on BODIAN DERMATOLOGY GROUP, P.C.
| 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.