Provider profile · NPI 1720750573

Active Dermatology Pllc

Dermatology · Brooklyn, NY · NPI 1720750573 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Dermatology

Enumerated

Sep 30, 2021

License(s)

Addresses on file

PurposeAddressCity/StatePhone
LOCATION488 DECATUR ST APT 2 Brooklyn, NY 11233-6682201-743-9134
MAILING488 DECATUR ST APT 2 Brooklyn, NY 11233-6682201-743-9134

View on NPPES registry ↗

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