OrganizationActive
1091 Southern Blvd Dermatology PLLC
NPI 1154004133 · Dermatology Physician · Bronx, NY
1091 Southern Blvd Dermatology PLLC is a Dermatology Physician organization in Bronx, NY (NPI 1154004133).
Provider details
- NPI number
- 1154004133
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Wendy Sanchez, Office Manager(347) 642-9802
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1091 Southern Blvd
Bronx, NY 10459-2417
Phone: (718) 401-7000
Fax: (917) 473-7878
Street-level locationGet directions
Mailing address
4037 74th St
Elmhurst, NY 11373-5603
Registry dates
- Enumerated
- 2023-08-08
- Last updated
- 2023-08-08
- Certified
- 2023-08-08
Frequently asked questions
- What is 1091 Southern Blvd Dermatology PLLC's NPI number?
- 1091 Southern Blvd Dermatology PLLC's National Provider Identifier (NPI) is 1154004133, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 1091 Southern Blvd Dermatology PLLC?
- 1091 Southern Blvd Dermatology PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is 1091 Southern Blvd Dermatology PLLC located?
- 1091 Southern Blvd Dermatology PLLC's practice location on file with NPPES is 1091 Southern Blvd, Bronx, NY 10459-2417.
- What is 1091 Southern Blvd Dermatology PLLC's phone number?
- The practice phone number listed in the NPPES registry for 1091 Southern Blvd Dermatology PLLC is (718) 401-7000.
- Who is the authorized official for 1091 Southern Blvd Dermatology PLLC?
- The authorized official listed on 1091 Southern Blvd Dermatology PLLC's NPPES record is Wendy Sanchez, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 1091 Southern Blvd Dermatology PLLC's NPI active?
- Yes — 1091 Southern Blvd Dermatology PLLC's NPI (1154004133) is active in the NPPES registry as of the last update on 2023-08-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.