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

Pine Street Dermatology, PC

Organization Specialist · NPI 1396822870

Pine Street Dermatology, PC is a Specialist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2006.

Licensed in
PA
In the registry since
2006
Specialties on file
2
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

1233 Locust St Ste 101
Philadelphia, PA 19107
Phone: (215) 735-2636
Fax: (215) 735-2634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence MD067435L (PA)
Specialist Taxonomy 174400000X · Licence MD067435L (PA)

Record details

NPI number1396822870
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Seana Covello — President · (215) 574-9101
NPI enumeratedNovember 1, 2006
Last updated in NPPESMay 11, 2012
Mailing address1233 Locust St., Suite 101, Philadelphia, PA 19107

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