Northeast Dermatology and Cosmetic Surgery Center

NPI #1609882836 in Gahanna, Ohio

Provider Information

NPI Number: 1609882836
Entity Type: Organization
Organization Name: Northeast Dermatology and Cosmetic Surgery Center
Primary Specialty: Dermatology
Enumeration Date: Jul 31, 2006
Last Updated: Nov 29, 2007

Practice Location

Address: 925 NORTH HAMILTON ROAD
Address 2: SUITE 100
City: Gahanna
State: Ohio
ZIP Code: 43230-4566
Phone: (614) 473-9519

Authorized Official

Name: DR. JOEL BAIN HERRON, M.D.
Title: MEDICAL DIRECTOR
Phone: (614) 473-9519

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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