Organization
ADVANCED DERMATOLOGY & SKIN SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORDECHAI M TARLOW M.D. (PRESIDENT)
(732) 905-9200
Entity
Organization
Contact information
Practice address
886 RIVER AVE, LAKEWOOD, NJ 08701-5220
(732) 905-9200
Mailing address
886 RIVER AVE, LAKEWOOD, NJ 08701-5220
(732) 905-9200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA07911600
NJ
Other
Enumeration date
06/24/2006
Last updated
06/25/2013
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