PHILADELPHIA CENTER FOR DERMATOLOGY, PC (NPI# 1598176554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598176554 |
| Entity Type | Organization |
| Organization Name | PHILADELPHIA CENTER FOR DERMATOLOGY, PC |
| Practice Address |
8400 Roosevelt Blvd Suite 200 Philadelphia PA 19152-2081 |
| Practice Telephone | 2675385045 |
| Practice Fax Number | 2675382153 |
| Mailing Telephone | 2675385045 |
| Mailing Fax Number | 2675382153 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-08-22 |
| Authorized Official Name | ATSUKO KODAMA (OWNER) |
| Authorized Official Telephone | 2675385045 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD440883 | PA | Allopathic & Osteopathic Physicians |
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MD440883 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
8400 ROOSEVELT BLVD SUITE 200 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19152-2081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508821158 | Medcath Partners, LLC | Clinic/Center | 8400 Roosevelt Blvd, Suite 220, Philadelphia, PA 19152-2012 | 2006-04-18 |
| 1942619390 | Jessica Rutstein Lazarus | Clinical Neuropsychologist | 8400 Roosevelt Blvd, Suite 206, Philadelphia, PA 19152-2081 | 2014-08-11 |
| 1821236340 | Advnatage Chiropractic and Rehabilitation | Chiropractor | 8400 Roosevelt Blvd, Suite 208, Philadelphia, PA 19152-2012 | 2009-01-22 |
| 1831366186 | Nicholas Stephen Patapis | Psychologist | 8400 Roosevelt Blvd, Suite 206, Philadelphia, PA 19152-2081 | 2008-05-14 |
| 1699976340 | Atsuko Kodama | Dermatology | 8400 Roosevelt Blvd, Suite 200, Philadelphia, PA 19152-2081 | 2007-05-30 |
| 1851418701 | Cynthia M Mitchell | Physical Therapy Assistant | 8400 Roosevelt Blvd, Philadelphia, PA 19152-2012 | 2007-03-24 |
| 1376694307 | Heather Michelle Akladios | Chiropractor | 8400 Roosevelt Blvd, Suite 208, Philadelphia, PA 19152-2012 | 2007-01-16 |
| 1033267463 | General & Vascular Surgical Group, P.c | Surgery | 8400 Roosevelt Blvd, Suite 220, Philadelphia, PA 19152-2081 | 2007-01-08 |
| 1629153770 | Wills Surgery Center of The Northeast | Clinic/Center | 8400 Roosevelt Blvd, Philadelphia, PA 19152-2012 | 2006-10-26 |
| 1154342368 | Northeast P.e.t Imaging, L.l.c | Clinic/Center | 8400 Roosevelt Blvd, Suite 208, Philadelphia, PA 19152-2012 | 2006-07-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412416 | Vishak Hari Kumar | Student in an Organized Health Care Education/Training Program | 2601 Holme Ave., Philadelphia, PA 19152 | 2020-06-19 |
| 1093298325 | Friendly Smile Dental Inc | Clinic/Center | 7608 Castor Ave 1 St Floor, Philadelphia, PA 19152 | 2018-09-12 |
| 1659857720 | Jaini Desai | Behavior Technician | 2982 Welsh Rd, Philadelphia, PA 19152 | 2018-07-12 |
| 1578066395 | Alexis Turbin | Physician Assistant | 8001 Roosevelt Blvd Ste 307, Philadelphia, PA 19152 | 2018-03-18 |
| 1215452982 | Nazareth Physician Services Inc | Social Worker | 2630 Holme Ave Ste 101, Philadelphia, PA 19152 | 2017-08-03 |
| 1437671955 | Anca & Leo LLC | Home Health | 9107 Revere St Ste 1, Philadelphia, PA 19152 | 2017-07-17 |
| 1407377435 | Erin O'neill Mcdermott | Nurse Practitioner | 1906 Tustin St., Philadelphia, PA 19152 | 2017-06-29 |
| 1700307766 | Vinayasree Shyam | Internal Medicine | 2601 Holme Avenue, Internal Medicine Residency, Philadelphia, PA 19152 | 2017-06-29 |
| 1497292833 | Joy & Comfort Home Care | Home Health | 2303 Stanwood St, Philadelphia, PA 19152 | 2017-01-24 |
| 1700320330 | Anna Lvovna Blinava | Pharmacist | 8330 Bustleton Ave Bells Market Pharmacy, Philadelphia, PA 19152 | 2016-12-16 |
| Find all providers in zip 19152 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205851888 | John T Seykora | Dermatology | 421 Curie Blvd, 1011 Brb, Philadelphia, PA 19104-4863 | 2006-07-13 |
| 1790722981 | Debra Jih | Dermatology | 822 Pine St Ste 2a, Philadelphia, PA 19107-6187 | 2006-05-31 |
| 1922570498 | Methodist Associates In Healthcare, Inc. | Dermatology | 3 Crescent Dr Fl 2, Philadelphia, PA 19112-1016 | 2018-12-21 |
| 1073902169 | University of Penn-medical Group | Dermatology | 3400 Spruce St, 2 Rhoads Pavilion, Philadelphia, PA 19104-4238 | 2015-01-13 |
| 1225426349 | University of Penn-medical Group | Dermatology | 3400 Civic Center Blvd, 1-330s Perelman Center, Philadelphia, PA 19104-5127 | 2014-12-23 |
| 1831320332 | Jefferson University Physicians | Dermatology | 833 Chestnut St, Suite 630, Jup Central Enollments, Philadelphia, PA 19107-4414 | 2009-07-31 |
| 1801821400 | Faizan M Alawi | Dermatology | 3400 Spruce Street, 2 Rhoads Pavilion, Philadelphia, PA 19104 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164684767 | Susan D Gisser | Dermatology | 515 Redleaf Rd, Wynnewood, PA 19096-1625 | 2008-06-26 |
| 1013965011 | Marisa Frances Baldassano | Dermatology | 828 Creekview Dr, Blue Bell, PA 19422-2729 | 2006-05-04 |
| 1174585418 | Ethel Marsha Ziselman | Dermatology | 2 Castlebar Ln, Malvern, PA 19355 | 2006-04-03 |
| 1336141373 | Thomas D Griffin | Dermatology | 3805 W Chester Pike, Newtown Square, PA 19073-2329 | 2005-08-10 |
| 1265431043 | Stacey E. Englander-turner | Dermatology | 940 E Haverford Rd, Suite 100, Bryn Mawr, PA 19010-3845 | 2005-07-14 |
| 1508865304 | Christine S Stanko | Dermatology | 775 E Lancaster Ave Ste 200, Villanova, PA 19085 | 2005-07-14 |
| 1154329035 | Nancy S House | Dermatology | 419 Walnut St, Sewickley, PA 15143-1535 | 2005-07-13 |
| 1629610936 | St Luke's Physician Group, Inc | Dermatology | 801 Ostrum St, Bethlehem, PA 18015-1000 | 2019-10-09 |
| 1902359912 | Dermatology Specialists of Montgomery County PC | Dermatology | 410 W Linfield Trappe Rd, Suite 240, Limerick, PA 19468 | 2016-07-26 |
| 1942566153 | Christina Marie Dicarlo | Dermatology | 320 E North Ave, Pittsburgh, PA 15212-4756 | 2012-04-02 |
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| City | PHILADELPHIA |
| Zip Code | 19152 |
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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.