NPI 1003082090

Omni Dermatology Incorporated

Organisation Dermatology Physician Glendale, AZ

Practice location

Address: 11851 N 51st Ave STE E130, Glendale, AZ 85304-2843
Phone: (480) 954-3919
Fax: (480) 954-3670

Authorised official

Name: Andrew J Racette
Title: President
Phone: (602) 369-3634

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 4311 (AZ)

Other Dermatology providers in Arizona →

Registry record

NPI: 1003082090
Entity type: Organization
NPI issued: 30 Apr 2008
Record last updated: 3 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.