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COMPLEXION MEDICAL PLLC
NPI 1497490429
Dermatology in New York, NY

Active since May 04, 2022CLIA 33D2272639 · Waiver
580 PARK AVE, NEW YORK, NY 10065(212) 752-3692 Get Directions Write a Review

NPPES record last updated: May 4, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Complexion Medical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COMPLEXION MEDICAL PLLC (NPI 1497490429) is a healthcare organization registered as a dermatology in New York, New York and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through November 27, 2026 and lists Bradley Glodny, Dermatologist/owner, as its authorized official.

NPPES Registry Identity

NPI1497490429
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCOMPLEXION MEDICAL PLLC
Location Address580 PARK AVENew York, NY 10065-7313
Mailing Address580 Park AveNew York, NY 10065-7313 · (212) 752-3692
Phone(212) 752-3692
Organization SubpartNo
Authorized OfficialBradley GlodnyDermatologist/owner · (516) 698-6864
Enumeration DateMay 4, 2022
NPPES CertifiedApril 29, 2022
✔ NPI 1497490429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
580 PARK AVE, New York, NY 10065
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2272639

Complexion Medical PLLC Park Avenue Dermatology · New York, NY
Active · expires Nov 27, 2026
CLIA Number33D2272639
Laboratory TypePhysician Office
Certificate Effective DateNovember 28, 2024
Certificate Expiration DateNovember 27, 2026
Laboratory DirectorBradley Glodny
Laboratory Phone(212) 752-3692
Laboratory LocationComplexion Medical PLLC Park Avenue Dermatology580 Park Avenue, New York, NY 10065
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEFFREY STEPHEN ROTH MD
Dermatology
580 PARK AVE
NEW YORK, NY 10065
New York County (212) 752-3692
RICHARD MICHAEL KUSHNER DPM
Podiatrist
580 PARK AVE, SUITE 1C
NEW YORK, NY 10065
New York County (212) 355-2875
PARK AVENUE DERMATOLOGY ASSOCIATES, PC
Dermatology
580 PARK AVE
NEW YORK, NY 10065
New York County (212) 752-3692
MAURICE M KHOSH MD PC
Otolaryngology (Facial Plastic Surgery)
580 PARK AVE, SUITE 1BE
NEW YORK, NY 10065
New York County (212) 339-9988
DR. ROBERT LESLIE WARNER MD
Dermatology
580 PARK AVE
NEW YORK, NY 10065
New York County (212) 752-3692

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Complexion Medical PLLC's NPI number?

The NPI number for Complexion Medical PLLC is 1497490429. It was assigned to this organization in the NPPES registry on May 4, 2022.

Where is Complexion Medical PLLC located?

Complexion Medical PLLC is located at 580 Park Ave, New York, NY 10065. The listed phone number is (212) 752-3692.

What is Complexion Medical PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Complexion Medical PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2272639) is associated with this NPI, valid through November 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Complexion Medical PLLC was last updated on May 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.