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General NPI Number Information
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NPI Number | 1144035189
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Entity Type | Organization
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Legal Business Name | PRIME DERMATOLOGY
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 2200 RIVER RD UNIT A
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City | POINT PLEASANT BORO
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State | NJ
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Zip | 08742-2297
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Country | US
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Telephone | 856-267-3245
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Fax | 908-741-8202
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Provider Business Mailing Address
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Address Line | 525 ROUTE 73 N STE 104
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City | MARLTON
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State | NJ
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Zip | 08053-3422
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Country | US
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Telephone | 856-267-3245
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Fax | 908-741-8202
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Authorized Official
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Title or Position | MANAGER
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Name | PATRICK LOMBARDI
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Credential | PA-C
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Telephone | 856-267-3245
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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 |
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License Number State |
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