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MARIWALLA DERMATOLOGY, PLLC
NPI 1891094322
Dermatology - MOHS-Micrographic Surgery in West Islip, NY

Active since March 23, 2011
1253 MONTAUK HWY, WEST ISLIP, NY 11795(631) 665-3376(631) 969-3376 Get Directions Write a Review

NPPES record last updated: April 20, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mariwalla Dermatology, Pllc NPPES

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

MARIWALLA DERMATOLOGY, PLLC (NPI 1891094322) is a healthcare organization registered as a mohs-micrographic surgery in West Islip, New York and active in the NPI registry since March 2011. The organization lists Kavita Mariwalla, Owner, as its authorized official.

NPPES Registry Identity

NPI1891094322
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameMARIWALLA DERMATOLOGY, PLLC
Location Address1253 MONTAUK HWYWest Islip, NY 11795-4916
Mailing Address1253 Montauk HwyWest Islip, NY 11795-4916 · (631) 665-3376 · Fax (631) 969-3376
Phone(631) 665-3376
Fax(631) 969-3376
Organization SubpartNo
Authorized OfficialKavita MariwallaOwner · (631) 665-3376
Enumeration DateMarch 23, 2011
Last NPPES UpdateApril 20, 2017
✔ NPI 1891094322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
1253 MONTAUK HWY, West Islip, NY 11795
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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 Compliance 33D2066049

Mariwalla Dermatology · West Islip, NY
Expired · Aug 11, 2026
CLIA Number33D2066049
Laboratory TypePhysician Office
Certificate Effective DateAugust 12, 2024
Certificate Expiration DateAugust 11, 2026
Laboratory DirectorDr. Kavita Mariwalla
Laboratory Phone(631) 665-3376
Laboratory LocationMariwalla Dermatology1253 Montauk Highway, West Islip, NY 11795
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

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

SAMANTHA NICOLINI RPA-C
Physician Assistant
1253 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 665-3376
MEGHAN JAMES PA-C
Physician Assistant
1253 MONTAUK HWY
WEST ISLIP, NY 11795
Suffolk County (631) 665-3376

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 Mariwalla Dermatology, PLLC's NPI number?

The NPI number for Mariwalla Dermatology, PLLC is 1891094322. It was assigned to this organization in the NPPES registry on March 23, 2011.

Where is Mariwalla Dermatology, PLLC located?

Mariwalla Dermatology, PLLC is located at 1253 Montauk Hwy, West Islip, NY 11795. The listed phone number is (631) 665-3376.

What is Mariwalla Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

When was this NPI record last updated?

The NPPES record for Mariwalla Dermatology, PLLC was last updated on April 20, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.