# BENEDETTO DERMATOLOGY,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dermatologic SurgiCenter
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811938863
- **Authorized official:** DR. ANTHONY V BENEDETTO D.O. (MEDICAL DIRECTOR)
- **Authorized official phone:** (215) 546-3666

## Contact information

- **Practice address:** 1200 LOCUST ST, DERMATOLOGIC SURGICENTER, PHILADELPHIA, PA 19107-5605
- **Practice address phone:** (215) 546-3666
- **Practice address fax:** (215) 546-6060
- **Mailing address:** 1200 LOCUST ST, DERMATOLOGIC SURGICENTER, PHILADELPHIA, PA 19107-5605
- **Mailing address phone:** (215) 546-3666
- **Mailing address fax:** (215) 546-6060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 04841500 | PA | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 12/16/2014