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Organization

NJ CERTIFIED DERMATOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAWRENCE L ANDERSON MD (OWNER)
(903) 521-6143
Entity
Organization

Contact information

Practice address
26 HIGHWAY 35 N, NEPTUNE, NJ 07753-4743
(732) 456-7777
(732) 797-9110
Mailing address
1580 LAKEWOOD RD, UNIT 16, TOMS RIVER, NJ 08755-3287
(732) 456-7777

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207NS0135X
Procedural Dermatology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0579912
NJ
01
517245
MEDICARE PTAN
NJ
Enumeration date
05/21/2016
Last updated
12/04/2025
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