MEDICARE: THE PRINCETON CENTER FOR DERMATOLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1275575094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PRINCETON CENTER FOR DERMATOLOGY, LLC

Provider Business Mailing Address
First Line	:	800 BUNN DR
Second Line	:	SUITE 201
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1968
Country	:	US
Telephone Number	:	609-924-1033
Fax Number	:	609-924-7055

Provider Business Practice Location Address
First Line	:	800 BUNN DR
Second Line	:	SUITE 201
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1968
Country	:	US
Telephone Number	:	609-924-1033
Fax Number	:	609-924-7055

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBYN B. NOTTERMAN
Credential	:	M.D.
Telephone Number	:	609-924-7690

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/19/2010

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Directions to “THE PRINCETON CENTER FOR DERMATOLOGY, LLC ” Practice Location

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