NPI 1417316274

Clark Dermatology, LLC

Organisation Dermatology Physician Staten Island, NY

Practice location

Address: 1324 Victory Blvd, Staten Island, NY 10301-3917
Phone: (718) 448-4488
Mailing address: 469 Morris Ave STE 3, Elizabeth, NJ 07208-2904

Authorised official

Name: Alexander Doctoroff
Title: Owner
Phone: (732) 574-1399

Registered specialties (3)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

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MOHS-Micrographic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X

Dermatopathology Physician

Allopathic & Osteopathic Physicians Taxonomy 207ND0900X

Registry record

NPI: 1417316274
Entity type: Organization
NPI issued: 22 Feb 2016
Record last updated: 5 May 2025

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.