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General NPI Number Information
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NPI Number | 1265130413
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Entity Type | Organization
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Legal Business Name | PATRIOT DERMATOLOGY, SCORP
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 638 LAWRENCEVILLE RD STE B
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-4208
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Country | US
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Telephone | 609-337-7643
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Fax | 609-337-7648
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Provider Business Mailing Address
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Address Line | 1 BECCA WAY
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City | ALLENTOWN
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State | NJ
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Zip | 08501-2100
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Country | US
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Telephone | 609-947-3786
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Fax |
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Authorized Official
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Title or Position | OWNER, DERMATOLOGIST
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Name | DR. ERINE A KUPETSKY
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Credential | DO
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Telephone | 609-947-3786
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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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