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ADVANCED DERMATOLOGY SURGERY CENTER NPI 1144657164


NPI Information

NPI: 1144657164
Provider Name: ADVANCED DERMATOLOGY SURGERY CENTER
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 31D0911125

Address:
4 HARTFORD DR
SUITE 3
TINTON FALLS, NJ
ZIP 07701
Phone: (732) 933-8500
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ADVANCED DERMATOLOGY SURGERY CENTER is a procedural dermatology dermatology in Tinton Falls, NJ. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). ADVANCED DERMATOLOGY SURGERY CENTER NPI is 1144657164. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 HARTFORD DR
SUITE 3
TINTON FALLS, NJ
ZIP 07701-929
Phone: (732) 933-8500
Fax: (732) 933-4177

The provider's authorized official is Glenn Kolansky .
The authorized official title is Owner and has the following contact phone number (732) 933-8500.

The CLIA number assigned to this NPI record is 31D0911125 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/4/2013 and was last updated on 5/5/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural Dermatology25MA06217900NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F57665MEDICARE UPINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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