1091 SOUTHERN BLVD DERMATOLOGY PLLC — NPI 1154004133 (Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) in BRONX, NY)

Plain-English Taxonomy Translation (207N00000X)

What Does Taxonomy Code 207N00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207N00000X translates in plain language to:
"Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)"

Primary Certifying / Accrediting Authority: American Board of Dermatology (ABD)
When Patients Should Consult: Changing moles, skin rashes, severe acne, eczema, psoriasis, fungal infections, hair loss, or skin cancer checks.

CMS Medicare Utilization & Part D Prescribing Benchmarks

Common Procedures & Clinical Prescribing Profile

Typical clinical procedures (Medicare Part B Utilization) and therapeutic classes (Medicare Part D Prescribing) associated with 1091 SOUTHERN BLVD DERMATOLOGY PLLC:

High-Volume Clinical Procedures & Diagnostics:

Full-Body Dermoscopy & Skin Cancer Screening
Shave, Punch & Excisional Skin Biopsy (CPT 11102–11107)
Cryotherapy Destruction of Actinic Keratoses & Viral Warts (CPT 17000)

Common Therapeutic & Prescribing Classes:

Topical Corticosteroids (Triamcinolone, Clobetasol) & Calcineurin Inhibitors
Topical & Oral Retinoids (Tretinoin, Adapalene, Isotretinoin)
Doxycycline, Minocycline & Antifungals (Terbinafine, Ketoconazole)

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	1154004133 (NPI-2 Organization / Facility)
Provider / Legal Name	1091 SOUTHERN BLVD DERMATOLOGY PLLC
Plain-English Specialty	Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) NUCC Code: `207N00000X` (Dermatology)
Certifying / Licensing Body	American Board of Dermatology (ABD)
Practice Location Address	1091 SOUTHERN BLVD, BRONX, NY, 104592417
Practice Telephone / Fax	Tel: 718-401-7000 \| Fax: 917-473-7878
Administrative Mailing Address	4037 74TH ST, ELMHURST, NY, 113735603
Enumeration & Last Sync	Enumerated: 2023-08-08 \| Updated: 2023-08-08
Authorized Official	WENDY SANCHEZ (Office Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1091 SOUTHERN BLVD, BRONX, NY, 104592417

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ADA & HIPAA Verification Note: Practice locations registered as primary LOCATION addresses under CMS NPPES are clinical service delivery sites (distinct from billing/mailing addresses).

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All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207N00000X` — Dermatology Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: N/A \| License: Verified \| Primary Taxonomy: Yes

1091 SOUTHERN BLVD DERMATOLOGY PLLC (NPI #1154004133)