DERMATOLOGY ASSOCIATES OF CENTRAL NEW YORK PLLC


Address: 4110 Medical Center Dr, Fayetteville, NY 13066-6613
Phone: 3156630100

DERMATOLOGY ASSOCIATES OF CENTRAL NEW YORK PLLC (NPI# 1336235639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336235639
Entity Type Organization
Organization Name DERMATOLOGY ASSOCIATES OF CENTRAL NEW YORK PLLC
Practice Address 4110 Medical Center Dr
Fayetteville
NY 13066-6613
Practice Telephone 3156630100
Practice Fax Number 3156630052
Mailing Telephone 3156630100
Mailing Fax Number 5856630052
Enumeration Date 2006-10-05
Last Update Date 2014-10-28
Authorized Official Name DR. AMIN FAZELI (PRESIDENT)
Authorized Official Telephone 3156630100
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology Allopathic & Osteopathic Physicians

Office Location

Street Address 4110 MEDICAL CENTER DR
City FAYETTEVILLE
State NY
Zip Code 13066-6613

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376537308 Vadjista Broumand Internal Medicine 4110 Medical Center Dr, Suite 110, Fayetteville, NY 13066 2005-09-06
1336510916 Melissa Roe Physician Assistant 4110 Medical Center Dr, Fayetteville, NY 13066-6613 2015-10-08
1871848481 Meghan L Doran Nurse Practitioner 4110 Medical Center Dr, Suite 100, Fayetteville, NY 13066-6613 2012-07-19
1023247608 Jessica Faye Bouchard Physician Assistant 4110 Medical Center Dr, Fayetteville, NY 13066-6613 2009-07-05
1558507251 Rachel Marie Damon Physician Assistant 4110 Medical Center Dr, Fayetteville, NY 13066-6613 2008-12-30
1992756209 Ellen E Powers Nurse Practitioner 4110 Medical Center Dr, Fayetteville, NY 13066-6613 2006-05-12
1215991005 Amin Fazeli Dermatology 4110 Medical Center Dr, Suite 110, Fayetteville, NY 13066-6613 2006-04-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457819963 Word Wellness Center, LLC Psychologist 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 2019-03-05
1629529060 Lorna Boyer Chase Marriage & Family Therapist 109 White Heron Circle, Fayetteville, NY 13066 2016-10-20
1699221432 Roman Batyuk Nurse Practitioner 4100 Medical Center Drive, Fayetteville, NY 13066 2016-08-31
1427405133 National Eye Care, Inc Optometrist 5160 Kinloch Circle, Fayetteville, NY 13066 2016-05-23
1013375328 Kristin Kukenberger Chiropractor 7000 E Genesee St Bldg B, Fayetteville, NY 13066 2016-02-01
1124394671 Susan Hartman Brenizer Marriage & Family Therapist 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 2012-03-29
1245541432 Rene L Converse Occupational Therapist 7200 E. Genesee Street, Fayetteville, NY 13066 2010-06-23
1689815805 Menorah Park Group Residents Clinic/Center 12 Jamar Drive, Dewitt, NY 13066 2009-03-18
1063677458 John Marcena Glezen Obstetrics & Gynecology 1 The Gazebo, Fayetteville, NY 13066 2008-07-24
1629232418 Tucker Martin Harris Otolaryngology 4000 Medical Center Dr # 117, Fayetteville, NY 13066 2008-07-11
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306061031 Northhills Dermatology Dermatology 3256 N Northhills Blvd, Fayetteville, AR 72703 2007-04-16
1679695233 Coressence Inc Dermatology 103 Hay St, Fayetteville, NC 28301-5649 2007-04-04
1629158142 Manfred S Rothstein Dermatology 1308 Medical Dr, Fayetteville, NC 28304 2006-10-17
1447350640 Alvin Harold Clair Dermatology 874 W. Lanier Ave, Suite 270, Fayetteville, GA 30214-7617 2006-09-25
1679682520 Lance B. Henry Dermatology 1444 E Stearns St, Suite 11, Fayetteville, AR 72703-6243 2006-08-30
1962519462 Ravenhill Dermatology Medical Clinic, P.C. Dermatology 110 Barcelona Dr, Fayetteville, NC 28303-4453 2006-08-23
1306860119 Douglas Walsh Dermatology 4110 Medical Center Drive, Dermatology Associates, Fayetteville, NY 13066-2075 2006-07-26
1285664623 Carla T Lee Dermatology 4120 Thornton Taylor Pkwy Ste F, Fayetteville, TN 37334-2292 2006-07-03
1396784443 Robert D Brown Dermatology 4375 N. Vantage Drive, Suite 305, Fayetteville, AR 72703 2006-06-05
1932154606 Wendell Weller Weed Dermatology 3256 N North Hills Blvd, Fayetteville, AR 72703 2006-05-23
Find all providers in FAYETTEVILLE

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City FAYETTEVILLE
Zip Code 13066

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Dataset Information

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.

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