Organization
ADVANCED DERMATOLOGY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN KOLANSKY MD (OWNER)
(732) 933-8500
Entity
Organization
Contact information
Practice address
4 HARTFORD DR, SUITE 3, TINTON FALLS, NJ 07701-4929
(732) 933-8500
(732) 933-4177
Mailing address
4 HARTFORD DR, SUITE 3, TINTON FALLS, NJ 07701-4929
(732) 933-8500
(732) 933-4177
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
25MA06217900
NJ
Other
Enumeration date
10/04/2013
Last updated
05/05/2015
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