Healthcare Provider Details

I. General information

NPI: 1528155900
Provider Name (Legal Business Name): FRANK KERN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 BAYSHORE AVE
BRIGANTINE NJ
08203-1927
US

IV. Provider business mailing address

2201 BAYSHORE AVE
BRIGANTINE NJ
08203-1927
US

V. Phone/Fax

Practice location:
  • Phone: 609-266-4777
  • Fax: 609-266-1673
Mailing address:
  • Phone: 609-266-4777
  • Fax: 609-266-1673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number25MA05012800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: