Organization
NJ CERTIFIED DERMATOLOGY PC
Active
Other names
DEDICATED DERMATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE L ANDERSON (MD/OWNER)
(903) 521-6143
Entity
Organization
Contact information
Practice address
2895 HAMILTON BLVD STE 202, ALLENTOWN, PA 18104-6172
(732) 456-7777
(848) 251-2189
Mailing address
1580 LAKEWOOD RD STE 16, TOMS RIVER, NJ 08755-3287
(732) 456-7777
(848) 251-2189
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103608008
—
PA
01
—
773906
MEDICARE PTAN
PA
Enumeration date
06/01/2016
Last updated
06/06/2023
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