Organization
TDG CENTER FOR DERMATOLOGIC CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON J SAMAHA MD (ASSISTANT SECRETARY)
(973) 571-2121
Entity
Organization
Contact information
Practice address
170 AVENUE AT THE CMN, SUITE 2, SHREWSBURY, NJ 07702-4803
(973) 571-2121
(732) 542-6392
Mailing address
347 MOUNT PLEASANT AVE, SUITE 205, WEST ORANGE, NJ 07052-2744
(973) 571-2121
(973) 498-0569
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA05082700
NJ
Other
Enumeration date
02/02/2017
Last updated
05/01/2017
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