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General NPI Number Information
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NPI Number | 1457613309
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Entity Type | Organization
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Legal Business Name | MORGAN DERMATOLOGY
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 3405 STATE ROUTE 33 FL 2
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City | NEPTUNE
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State | NJ
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Zip | 07753-2766
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Country | US
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Telephone | 732-508-9390
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Fax | 732-774-4028
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Provider Business Mailing Address
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Address Line | 3405 STATE ROUTE 33 FL 2
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City | NEPTUNE
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State | NJ
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Zip | 07753-2766
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Country | US
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Telephone | 732-508-9390
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Fax | 732-774-4028
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | DIANE MORGAN
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Credential |
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Telephone | 732-508-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MA08863000
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License Number State | NJ
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