Healthcare Provider Details

I. General information

NPI: 1023089554
Provider Name (Legal Business Name): ROBERT NOSSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONTEMPORARY DERMATOLOGY 3880 FALMOUTH RD
MARSTONS MILLS MA
02648
US

IV. Provider business mailing address

159 UPPER MOUNTAIN AVE
MONTCLAIR NJ
07042-1905
US

V. Phone/Fax

Practice location:
  • Phone: 508-492-3200
  • Fax: 508-492-3232
Mailing address:
  • Phone: 201-704-5557
  • Fax: 508-492-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMA07221300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: