Basic Information
| Provider Information | |||||||||
| NPI: | 1336634096 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ES DERMATOLOGY, PLLC | ||||||||
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| OtherOrganizationName: | BERNSTEIN MEDICAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2701 QUEENS PLZ N FL 10 | ||||||||
| Address2: | |||||||||
| City: | LONG ISLAND CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111014022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122833000 | ||||||||
| FaxNumber: | 6466653604 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 E 55TH ST FL 11 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100224551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128262400 | ||||||||
| FaxNumber: | 6466653604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2018 | ||||||||
| LastUpdateDate: | 06/26/2018 | ||||||||
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| AuthorizedOfficialLastName: | SCHWEIGER | ||||||||
| AuthorizedOfficialFirstName: | ERIC | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2122833000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 233192 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.