Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Advanced Dermatology of New York PC

Organization Dermatology Physician · NPI 1508048240

Advanced Dermatology of New York PC is a Dermatology Physician in Bronx, New York. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

291 E 149th St
Bronx, NY 10451-5601
Phone: (718) 742-1000
Fax: (212) 765-3210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1508048240
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lawrence Jaeger — Officer · (212) 262-2500
Other names Advanced Dermatology Associates
NPI enumeratedDecember 5, 2007
Last updated in NPPESDecember 10, 2014
Mailing address200 Central Park S, Suite 107, New York, NY 10019-1436

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