| Dr Tanasha Simela, DO | |
| 1065 Southern Boulevard, Medical Affairs, Bronx, NY 10459 | |
| (718) 589-2440 | |
| (718) 991-4516 | 
| Full Name | Dr Tanasha Simela | 
|---|---|
| Gender | Female | 
| Speciality | Dermatology | 
| Location | 1065 Southern Boulevard, Bronx, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1538321997 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207N00000X | Dermatology | 25MB10158200 (New Jersey) | Secondary | 
| 207N00000X | Dermatology | 290569 (New York) | Primary | 
| Entity Name | The Dermatology Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1962428474 PECOS PAC ID: 7911971510 Enrollment ID: O20040820000169 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Tanasha Simela, DO 725 River Rd Ste 32-114, Edgewater, NJ 07020-1171 Ph: (844) 433-7636 | Dr Tanasha Simela, DO 1065 Southern Boulevard, Medical Affairs, Bronx, NY 10459 Ph: (718) 589-2440 | 
| Maira Fonseca,  Dermatology Medicare: Accepting Medicare Assignments Practice Location: 234 E 149th St, Bronx, NY 10451 Phone: 212-639-3210 | |
| Dr. Ali Nicole Dana, MD,PHD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 130 W Kingsbridge Rd, Bronx, NY 10468 Phone: 718-584-9000 | |
| Dr. Mina Daoud Aziz, MD Dermatology Medicare: Medicare Enrolled Practice Location: 3411 Wayne Ave, Bronx, NY 10467 Phone: 718-920-2680 | |
| Carson Thomas Kirkpatrick, MD Dermatology Medicare: Medicare Enrolled Practice Location: 3514 Bainbridge Ave, Bronx, NY 10467 Phone: 866-633-8255 | |
| Dr. Shira Wieder, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3333 Henry Hudson Pkwy Apt 1b, Bronx, NY 10463 Phone: 718-543-0900 | |
| Dr. Richard W Green, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2100 Bartow Ave, Suite 211, Bronx, NY 10475 Phone: 718-671-1000 Fax: 212-765-3210 | |
| Dr. Caroline Patricia Halverstam, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 1250 Waters Pl, Tower 2, 6th Floor, Bronx, NY 10461 Phone: 866-633-8255 |