Mimi G Bansal, MD
Mimi G Bansal, MD is a Procedural Dermatology Physician in Lake Success, New York. Licensed in New York. Registered with an NPI since 2006.
- Licensed in
- NY
- In the registry since
- 2006
Practice location Address checks out
2001 Marcus Ave Ste N218Lake Success, NY 11042
Phone: (516) 352-2700
Fax: (516) 437-6904
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Specialties & licences
| Procedural Dermatology Physician (primary) | Taxonomy 207NS0135X · Licence 2122661 (NY) |
|---|
Record details
| NPI number | 1003978669 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mimi Bansal — Owner · (516) 352-2700 |
| NPI enumerated | December 13, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 2 Polo Dr, Old Westbury, NY 11568-1043 |