1225482839 NPI number — UNITED SKIN SPECIALISTS MISSOURI LTD, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225482839 NPI number — UNITED SKIN SPECIALISTS MISSOURI LTD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED SKIN SPECIALISTS MISSOURI LTD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225482839
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33 E 33RD ST FL 12
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-5362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-283-3000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 CHESTERFIELD PKWY E
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63017-2167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-878-3839
Provider Business Practice Location Address Fax Number:
314-878-6575
Provider Enumeration Date:
04/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWEIGER
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
212-283-3000

Provider Taxonomy Codes

  • Taxonomy code: 207ND0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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