Organization
COSMETIC AND DERMATOLOGIC SURGERY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOJ THAKKER M.D. (OWNER)
(802) 310-0664
Entity
Organization
Contact information
Practice address
719 N BEERS ST, SUITE 2G, HOLMDEL, NJ 07733-1522
(802) 310-0664
Mailing address
8 RIVERSIDE LN, HOLMDEL, NJ 07733-2084
(802) 310-0664
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
25MA08829200
NJ
207W00000X
Ophthalmology Physician
25MA08673200
NJ
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
25MA08673200
NJ
Other
Enumeration date
02/21/2011
Last updated
02/21/2011
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