Organization
COSMETIC AND DERMATOLOGIC SURGERY ASSOCIATES LLC
Active
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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