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General NPI Number Information
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NPI Number | 1073729018
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Entity Type | Organization
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Legal Business Name | ALTA DERMATOLOGY & SKIN CARE CENTER, LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 701 COOPER RD SUITE #13
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City | VOORHEES
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State | NJ
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Zip | 08043-3800
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Country | US
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Telephone | 856-344-2849
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Fax | 856-344-2938
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Provider Business Mailing Address
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Address Line | 701 COOPER RD SUITE #13
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City | VOORHEES
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State | NJ
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Zip | 08043-3800
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Country | US
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Telephone | 856-344-2849
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Fax | 856-344-2938
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Authorized Official
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Title or Position | OWNER
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Name | DAVID HAL FINKELSTEIN
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Credential | M.D.
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Telephone | 856-344-2849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MA068924
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License Number State | NJ
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