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

Park Avenue Dermatology

Organization Legal Medicine · NPI 1447642103

Park Avenue Dermatology is a Legal Medicine in Staten Island, New York. Licensed in New York. Registered with an NPI since 2015.

Licensed in
NY
In the registry since
2015

Practice location Address checks out

31 Tioga St
Staten Island, NY 10301
Phone: (718) 981-5040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Legal Medicine (primary) Taxonomy 173000000X · Licence 018032 (NY)

Record details

NPI number1447642103
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Dick — Ofice Manager · (718) 981-5040
NPI enumeratedMarch 4, 2015
Last updated in NPPESMarch 4, 2015
Mailing address31 Tioga St, Staten Island, NY 10301

Other providers in Staten Island