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General NPI Number Information
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NPI Number | 1285857110
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Entity Type | Organization
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Legal Business Name | HAMETZ & PICASCIA DERMATOLOGY ASSOCIATES
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 04/27/2009
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Provider Practice Location Address
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Address Line | 77 SCHANCK RD # 55 SUITE B-3
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City | FREEHOLD
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State | NJ
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Zip | 07728-2964
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Country | US
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Telephone | 732-462-9800
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Fax | 732-308-1647
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Provider Business Mailing Address
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Address Line | 77 SCHANCK RD # 55 SUITE B-3
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City | FREEHOLD
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State | NJ
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Zip | 07728-2964
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Country | US
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Telephone | 732-462-9800
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Fax | 732-308-1647
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IRWIN HAMETZ
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Credential | M.D.
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Telephone | 732-462-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA34616
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License Number State | NJ
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