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General NPI Number Information
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NPI Number | 1073542155
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Entity Type | Organization
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Legal Business Name | LAWRENCEVILLE DERMATOLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 74 FRANKLIN CORNER RD
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2102
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Country | US
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Telephone | 609-896-3232
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Fax | 609-896-3233
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Provider Business Mailing Address
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Address Line | 74 FRANKLIN CORNER RD
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2102
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Country | US
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Telephone | 609-896-3232
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Fax | 609-896-3233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN LEE HUBERT
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Credential | MD
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Telephone | 609-896-3232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MA65743
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License Number State | NJ
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