MODERN DERMATOLOGY PLLC (NPI# 1184068017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184068017 |
| Entity Type | Organization |
| Organization Name | MODERN DERMATOLOGY PLLC |
| Practice Address |
65 Broadway New York NY 10006-2503 |
| Practice Telephone | 2123796477 |
| Mailing Telephone | 2123796477 |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2014-04-01 |
| Authorized Official Name | DR. KATHRYN FREW (OWNER) |
| Authorized Official Telephone | 2123796477 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 236599 | NY | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356891576 | Modern Dermatology Pllc | Dermatology | 3485 Fannin St, Beaumont, TX 77701-3807 | 2016-10-12 |
| Street Address |
65 BROADWAY |
| City | NEW YORK |
| State | NY |
| Zip Code | 10006-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437182375 | Jordan C. Stern | Otolaryngology | 65 Broadway, Suite 901, New York, NY 10006-2503 | 2006-07-07 |
| 1942849401 | Joseph Charles Cestaro | Physical Therapist | 65 Broadway, New York, NY 10006-2503 | 2020-01-02 |
| 1700443280 | Elizabeth Roper | Acupuncturist | 65 Broadway, New York, NY 10006-2503 | 2019-05-21 |
| 1578009270 | Ny Mobile Medical PC | Specialist | 65 Broadway, Ste 903, New York, NY 10006-2503 | 2017-01-18 |
| 1801270715 | Rosemary Ward | Nurse Practitioner | 65 Broadway, Suite 903, New York, NY 10006 | 2015-07-10 |
| 1588053557 | New York Speech & Voice Lab Pllc | Speech-Language Pathologist | 65 Broadway, Suite 822, New York, NY 10006-2503 | 2015-01-14 |
| 1154726479 | Wall Street Podiatry PC | Podiatrist | 65 Broadway, Unit 1103, New York, NY 10006-2503 | 2014-10-29 |
| 1487061065 | Erika Hellwig Mental Health Counselor Pllc | Counselor | 65 Broadway, 844, New York, NY 10006-2503 | 2014-07-16 |
| 1902220585 | Katie Lorenzo | Social Worker | 65 Broadway, 505, New York, NY 10006-2503 | 2014-02-18 |
| 1861736092 | John J Ferrera | Clinical Neuropsychologist | 65 Broadway, Suite 812, New York, NY 10006-2503 | 2012-11-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620313 | Retina Labs (usa), Inc. | Technician/Technologist | 165 Broadway - One Liberty Plaza, Suite 2301, New York City, NY 10006 | 2019-10-15 |
| 1437626140 | Conscientiamd PC | Psychiatry & Neurology | 115 Broadway Suite 1800 (room 25), New York, NY 10006 | 2018-10-31 |
| 1720563232 | Harveen Kaur | Physical Therapist | 65 Broadway, Ste. 603, New York, NY 10006 | 2018-10-01 |
| 1871032367 | Joanne Herskovits | Speech-Language Pathologist | 90 Trinity Place, Leadership and Public Service High School, New York, NY 10006 | 2017-02-16 |
| 1457801318 | Lifetime Physical Therapy | Clinic/Center | 2 Rector St # 1301, Lifetime Physical Therapy, New York, NY 10006 | 2016-10-04 |
| 1649647959 | Progyny, Inc. | Exclusive Provider Organization | 1 Liberty Plaza, 47th Floor, New York, NY 10006 | 2015-08-24 |
| 1801207022 | Jane Arkinstall | Social Worker | 39 Broadway Suite 200, Mjhs, New York, NY 10006 | 2014-05-09 |
| 1487077665 | Jacob Perlow Hospice | Medicare Defined Swing Bed Unit | 39 Broadway, Suite 200, Ny, NY 10006 | 2014-01-24 |
| 1003249301 | Calvin C. Krom IIi | Emergency Medicine | 39 Broadway Fl 3, New York, NY 10006 | 2013-08-10 |
| 1740535103 | Carol Lynn Say Tan | Physical Therapist | 61 Broadway Suite 2824, New York, NY 10006 | 2012-07-20 |
| Find all providers in zip 10006 | ||||
| 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 |
|---|---|---|---|---|
| 1275148652 | Gloria Li | Specialist | 959 1st Ave, New York, NY 10022-6649 | 2020-09-11 |
| 1700495041 | Ana Rosa Perez | Specialist | 318 E 116th St, New York, NY 10029-1506 | 2020-07-22 |
| 1659995801 | Theodore Nathan Raosen | Specialist | 128 Pinehurst Ave Apt B61, New York, NY 10033-1755 | 2020-06-03 |
| 1255954301 | Courtney Foster | Specialist | 222 E 34th St # 13, New York, NY 10016-4842 | 2020-05-23 |
| 1396371852 | Laquanique Louise Lake | Specialist | 116west 32nd Street, New York, NY 10001-3212 | 2020-03-17 |
| 1205460524 | Yasmin El-hifnawi Cooper | Specialist | 2572 Frederick Douglass Blvd Unit B, New York, NY 10030-2106 | 2020-02-25 |
| 1376175992 | Patricia Ann Ebert | Specialist | 310 E 102nd St Apt 9d, New York, NY 10029-5607 | 2020-02-11 |
| 1912547928 | Roberto Manuel Gonzalez | Specialist | 250 W 108th St, New York, NY 10025-2956 | 2020-01-08 |
| 1659918639 | Delores Cody Oppecker | Specialist | 455 Fort Washington Ave Apt 53, New York, NY 10033-4631 | 2019-12-09 |
| 1174160543 | Jazmin Bernal | Specialist | 765 Riverside Dr, 3n, New York, NY 10032 | 2019-12-04 |
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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.