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General NPI Number Information
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NPI Number | 1205431574
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY PARTNERS
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 901 W MAIN ST STE 201
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City | FREEHOLD
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State | NJ
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Zip | 07728-2537
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Country | US
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Telephone | 732-222-2250
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Fax | 888-218-8335
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Provider Business Mailing Address
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Address Line | 3 HEYWARD HILLS DR
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City | HOLMDEL
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State | NJ
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Zip | 07733-1403
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Country | US
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Telephone | 650-274-5513
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Fax | 732-596-7629
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Authorized Official
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Title or Position | OWNER/MD
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Name | DR. SWARNA P SIVANESAN
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Credential | MD
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Telephone | 770-630-8299
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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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