ADVANCED DERMATOLOGY OF COOP CITY PC (NPI# 1811207210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811207210 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY OF COOP CITY PC |
| Other Organization Name | ADVANCED DERMATOLOGY ASSOCIATES |
| Practice Address |
2100 Bartow Ave Suite 211 Bronx NY 10475-4614 |
| Mailing Address |
200 Central Park S Suite 107 New York NY 10019-1436 |
| Practice Telephone | 7186711000 |
| Practice Fax Number | 2127653210 |
| Mailing Telephone | 2122622500 |
| Mailing Fax Number | 2127653210 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |
| Authorized Official Name | LAWRENCE D JAEGER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2122622500 |
| Authorized Official Credential | D.O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Advanced Dermatology Associates | Doing Business As Name - Organization |
| Street Address |
2100 BARTOW AVE SUITE 211 |
| City | BRONX |
| State | NY |
| Zip Code | 10475-4614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518964923 | Advanced Dermatology of New York PC | Dermatology | 2100 Bartow Ave, Ste 211, Bronx, NY 10475-4614 | 2005-06-30 |
| 1427440445 | Paul Michael Williams | Dentist | 2100 Bartow Ave, 218b, Bronx, NY 10475-4614 | 2015-02-27 |
| 1164814588 | Sofia Kavakoglou | Dentist | 2100 Bartow Ave, #218b, Bronx, NY 10475-4614 | 2015-02-22 |
| 1659769602 | Hadeel Alkhairw | Internal Medicine | 2100 Bartow Ave, Bronx, NY 10475-4614 | 2014-12-29 |
| 1639504418 | Idalia R Mendez | Social Worker | 2100 Bartow Ave, Bronx, NY 10475-4614 | 2013-09-11 |
| 1023358009 | Chiropractic Motion Diagnostic. LLC | Chiropractor | 2100 Bartow Ave, Bronx, NY 10475-4614 | 2013-02-27 |
| 1891035150 | Vision Center Optical Inc | Technician/Technologist | 2100 Bartow Ave, Suite 216c, Bronx, NY 10475-4614 | 2013-02-25 |
| 1003168295 | Smile Savers Orthodo | Dentist | 2100 Bartow Ave, 218, Bronx, NY 10475-4614 | 2012-10-11 |
| 1295011195 | Dental Smiles Unlimited, PC | Clinic/Center | 2100 Bartow Ave, Suite 218b, Bronx, NY 10475-4614 | 2011-10-25 |
| 1477885879 | Adelaida Mijos Laga | Physical Therapist | 2100 Bartow Ave, Suite 227, Bronx, NY 10475-4614 | 2010-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973048 | Sharon Antoinette Hall | Registered Nurse | 2552 Pelham Bay Park West, Apt 1 D, 2551 Pelham Bay Park West, Bronx, NY 10475 | 2019-07-11 |
| 1265912042 | Bartow Pharmacy Inc. | Pharmacy | 500-5 Baychester Ave. Store #5, Bronx, NY 10475 | 2018-08-21 |
| 1518465996 | Jacqueline Caraballo | Nurse Practitioner | 100 De Kruif Place Apt 27h, Bronx, NY 10475 | 2018-01-31 |
| 1093227142 | Rachel Obeng Mireku | Licensed Practical Nurse | 140 Dekruif Place, Apt # 26k, Bronx, NY 10475 | 2017-10-30 |
| 1023534518 | Nelson Merritt Hall | Chiropractor | 2100 Bartow Ave, Ste #227, Bronx, NY 10475 | 2017-08-17 |
| 1245769363 | Sharon Holland Johnson | Licensed Practical Nurse | 140 Dekruif Pl, Bronx, NY 10475 | 2017-06-12 |
| 1740719152 | Nadia S Etienne | Licensed Practical Nurse | 120 De Kruif Place, Apt 18h, Bronx, NY 10475 | 2017-06-08 |
| 1407385891 | Ashley N Freeze | Case Manager/Care Coordinator | 140 Darrow Place Suite 24e, Bronx, NY 10475 | 2017-06-08 |
| 1912454091 | Usth.inc | Early Intervention Provider Agency | 120 Coop City Blvd, 21-f, Bronx, NY 10475 | 2016-09-06 |
| 1447626130 | Zelda Boomer | Registered Nurse | 920 Coop City Blvd Bx. Ny 10475, Bronx, NY 10475 | 2015-08-17 |
| Find all providers in zip 10475 | ||||
| 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 |
|---|---|---|---|---|
| 1881206027 | Mirna Aracelis Vasquez | Specialist | 1691 E 174th St Apt 3a, Bronx, NY 10472-1733 | 2020-08-19 |
| 1588273874 | Lorens Dominguez | Specialist | 1280 Commonwealth Ave Apt 2l, Bronx, NY 10472-2816 | 2020-07-23 |
| 1184242935 | Mayelin Y Rodriguez | Specialist | 2910 Valentine Ave Apt 26a, Bronx, NY 10458-2762 | 2020-07-08 |
| 1972120251 | Osaze Monica Igbineweka | Specialist | 590 Eagle Ave, Bronx, NY 10455-2915 | 2020-07-02 |
| 1285253948 | Omaira Alfonsina Tejada Amaro | Specialist | 234 E 149th St Ste 4-20, Bronx, NY 10451-5504 | 2020-04-13 |
| 1417586595 | Vascular Medicine of New York, Pllc | Specialist | 3250 Westchester Ave Ste 201, Bronx, NY 10461-4580 | 2020-04-02 |
| 1154954493 | Belmont Medical PC | Specialist | 2525 Belmont Ave, Bronx, NY 10458 | 2020-02-14 |
| 1043850423 | Katherine Hambel | Specialist | 283 E 234th St Apt 2e, Bronx, NY 10470-2212 | 2020-01-13 |
| 1801435953 | Delis S Ventura | Specialist | 74 Van Cortlandt Park S Apt Ee31, Bronx, NY 10463-3075 | 2020-01-06 |
| 1528606282 | Steffani M Russo | Specialist | 3058 Bailey Ave Apt 2s, Bronx, NY 10463-5820 | 2019-12-12 |
| Find all providers in BRONX | ||||
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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.