Organization
TDG SURGERY, LLC
Active
Parent organization
THE DERMATOLOGY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE DERMATOLOGY GROUP
Authorized official
ANGELA SHORT (VICE PRESIDENT)
(973) 571-2121
Entity
Organization
Contact information
Practice address
140 N RTE 17, SUITE 105, PARAMUS, NJ 07652-2809
(973) 571-2121
Mailing address
140 N RTE 17, SUITE 105, PARAMUS, NJ 07652-2809
(973) 571-2121
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2012
Last updated
10/10/2012
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