Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pine Street Dermatology, PC

Organization Specialist · NPI 1396822870

Pine Street Dermatology, PC provides Specialist services in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2006.

Licensed in
PA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1233 Locust St Ste 101
Philadelphia, PA 19107 Not confirmed with CMS for 14 years — call before visiting
Phone: (215) 735-2636
Fax: (215) 735-2634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence MD067435L (PA)
Specialist Taxonomy 174400000X · Licence MD067435L (PA)

Record details

NPI number1396822870
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Seana Covello — President · (215) 574-9101
NPI enumeratedNovember 1, 2006
Last updated in NPPESMay 11, 2012
Mailing address1233 Locust St., Suite 101, Philadelphia, PA 19107

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