Healthcare Provider Details

I. General information

NPI: 1770896029
Provider Name (Legal Business Name): COSMEDICAL PLASTIC SURGERY & DERMATOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 EVELYN ST
PARAMUS NJ
07652-2901
US

IV. Provider business mailing address

351 EVELYN ST
PARAMUS NJ
07652-2901
US

V. Phone/Fax

Practice location:
  • Phone: 201-265-1300
  • Fax: 201-265-3737
Mailing address:
  • Phone: 201-265-1300
  • Fax: 201-265-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA DORIA BAXT
Title or Position: OWNER/ MEDICAL DIRECTOR
Credential: MD
Phone: 201-265-1300