Healthcare Provider Details

I. General information

NPI: 1861838484
Provider Name (Legal Business Name): DERMATOLOGY GROUP OF CENTRAL NEW JERSEY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MONROE STREET
BRIDGEWATER NJ
08807-3001
US

IV. Provider business mailing address

3 MONROE STREET
BRIDGEWATER NJ
08807-3001
US

V. Phone/Fax

Practice location:
  • Phone: 908-526-0526
  • Fax: 908-595-0123
Mailing address:
  • Phone: 908-526-0526
  • Fax: 908-595-0123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT SCHNEIDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 908-526-0526