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General NPI Number Information
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NPI Number | 1518906403
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY SKIN CARE & LASER CENTER, P.C.
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 127 CHURCH RD SUITE 100
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City | MARLTON
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State | NJ
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Zip | 08053-9402
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Country | US
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Telephone | 856-810-9888
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Fax | 856-810-9889
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Provider Business Mailing Address
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Address Line | 127 CHURCH RD SUITE 100
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City | MARLTON
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State | NJ
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Zip | 08053-9402
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Country | US
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Telephone | 856-810-9888
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Fax | 856-810-9889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBIN MERLE LEVIN
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Credential | M.D.
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Telephone | 856-810-9888
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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 | 25MA06657000
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License Number State | NJ
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