Dermatology & Plastic Surgery of Northern New York PC

NPI #1598852329 in Watertown, New York

Provider Information

NPI Number: 1598852329
Entity Type: Organization
Organization Name: Dermatology & Plastic Surgery of Northern New York PC
Primary Specialty: Specialist
Enumeration Date: Oct 5, 2006
Last Updated: Feb 18, 2009

Practice Location

Address: 826 WASHINGTON STREET
Address 2: SUITE 104
City: Watertown
State: New York
ZIP Code: 13601-4065
Phone: (315) 786-1500

Authorized Official

Name: DR. BARBARA LICZNERSKI, MD
Title: PRESIDENT
Phone: (315) 786-1500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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