Provider Demographics
NPI:1487064499
Name:VIP DERMATOLOGY
Entity type:Organization
Organization Name:VIP DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EYAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEVIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-288-6100
Mailing Address - Street 1:1220 AVENUE P
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1009
Mailing Address - Country:US
Mailing Address - Phone:718-375-7546
Mailing Address - Fax:718-376-6475
Practice Address - Street 1:880 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4951
Practice Address - Country:US
Practice Address - Phone:212-288-6100
Practice Address - Fax:212-472-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208782174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty