OrganizationAdvanced Dermatology Of The Bronx Pc(Advanced Dermatology Associates)SpecialistOther Service ProvidersPractice Address291 E 149th St, Bronx, NY 10451-5601(718) 742-1000(212) 262-2500PECOS EnrollmentBased on the most recent information from CMS, provider Advanced Dermatology Of The Bronx Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1477863876Provider TypeOrganizationFull NameAdvanced Dermatology Of The Bronx PcOther NameAdvanced Dermatology AssociatesSubpartNoEnumeration Date10/19/2010Last Updated10/19/2010Contact InformationPractice LocationPractice Address291 E 149th St, Bronx, NY 10451-5601Phone(718) 742-1000Fax(212) 765-3210Mailing LocationMailing Address200 Central Park S, Suite 107, New York, NY 10019-1436Phone(212) 262-2500Fax(212) 765-3210Authorized OfficialNameJaeger, Lawrence D (Medical Director)Phone(212) 262-2500Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseUnlisted Issuer