| Lauren Moy, MD | |
| 2160 S 1st Ave, Maywood, IL 60153 | |
| (708) 216-9000 | |
| Not Available | 
| Full Name | Lauren Moy | 
|---|---|
| Gender | Female | 
| Speciality | Dermatology | 
| Location | 2160 S 1st Ave, Maywood, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1275997942 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207N00000X | Dermatology | 125.071916 (Illinois) | Primary | 
| Entity Name | Golden State Dermatology Associates, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1700860871 PECOS PAC ID: 1052418175 Enrollment ID: O20070523000605 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lauren Moy, MD 2160 S 1st Ave, Maywood, IL 60153-3328 Ph: () - | Lauren Moy, MD 2160 S 1st Ave, Maywood, IL 60153 Ph: (708) 216-9000 | 
| Zisansha Zahirsha,  Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-4533 Fax: 708-216-5446 | |
| Mathew Joseph,  Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
| James Swan, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, (321 Lagrange Rd., Lagrande Park, Il.60526), Maywood, IL 60153 Phone: 708-485-1020 Fax: 708-485-1173 | |
| Rachit Gupta, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
| Dr. Jenna Janiga Lullo, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
| Dr. Farinoosh Dadrass, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-4962 |