# SHORE DERMATOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629253513
- **Authorized official:** DR. RISA JILL GORIN DO (SOLE MEMBER)
- **Authorized official phone:** (732) 462-5200

## Contact information

- **Practice address:** 9 PROFESSIONAL CIRCLE, SUITE 103, COLTS NECK, NJ 07722
- **Practice address phone:** (732) 462-5200
- **Practice address fax:** (732) 462-5212
- **Mailing address:** 9 PROFESSIONAL CIRCLE, SUITE 103, COLTS NECK, NJ 07722
- **Mailing address phone:** (732) 462-5200
- **Mailing address fax:** (732) 462-5212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 25MB07615100 | NJ | Yes |

## Other

- **Enumeration date:** 01/09/2008
- **Last updated:** 09/15/2008