Healthcare Provider Details

I. General information

NPI: 1790082535
Provider Name (Legal Business Name): ABOVE ALL DERMATOLOGY DELAWARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N. CLAYTON STREET ST. FRANCES HOSPITAL MEDICAL BUILDING
WILMINGTON DE
19805
US

IV. Provider business mailing address

PO BOX 2133
TOMS RIVER NJ
08754-2133
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-4700
  • Fax:
Mailing address:
  • Phone: 732-244-4700
  • Fax: 732-244-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RAMI GEFFNER
Title or Position: MD
Credential: MD
Phone: 732-244-4700