Advanced Dermatology Surgery Center

NPI 1144657164 - Dermatology - 207NS0135X

NPI Details
NPI 1144657164
Enumeration Date 10/04/2013
Last Updated 05/05/2015
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name GLENN GLENN
Position OWNER
Phone (732) 933-8500
Fax (732) 933-4177
Practice Location
4 HARTFORD DR
SUITE 3
TINTON FALLS NJ, 07701-4929, US
Phone (732) 933-8500
Fax (732) 933-4177
Business Location
4 HARTFORD DR
SUITE 3
TINTON FALLS NJ, 07701-4929, US
Phone (732) 933-8500
Fax (732) 933-4177
Toxanomy
Taxonomy Code 207NS0135X
License State New Jersey
License Number 25MA06217900
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According to our database, Advanced Dermatology Surgery Center NPI is 1144657164, taxonomy code is 207NS0135X and license number is 25MA06217900, license state is located at New Jersey. Advanced Dermatology Surgery Center physically located at 4 Hartford Dr, Tinton Falls NJ, 07701-4929. NPI Number 1033115704 has the healthcare provider type.

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1144657164 NPI number is provided on an as is basis without warranty of any kind. 1144657164 is maintained by the National Plan & Provider Enumeration System. The contents of Advanced Dermatology Surgery Center are for informational purposes only.