Organization
ASSOCIATES IN DERMATOLOGY AND COSMETIC SURGERY THE MILLBURN LASER CENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SCOTT SIEGEL MD (OWNER)
(973) 376-8500
Entity
Organization
Contact information
Practice address
12 E WILLOW ST, MILLBURN, NJ 07041-1417
(973) 376-8500
(973) 376-1820
Mailing address
12 EAST WILLOW STREET, MILLBURN, NJ 07041-1737
(973) 376-8500
(973) 376-1820
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MC68842
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0439712000
AMERIHEALTH GROUP PROVIDER NO.
NJ
01
—
070015262
RAILROAD MEDICARE PROVIDER NO.
—
01
—
2299713
AETNA GROUP PIN
NJ
01
—
2299763
GHI PROVIDER NO.
NJ
01
—
DA1464
RAILROAD MEDICARE GROUP PIN
NJ
Enumeration date
03/22/2007
Last updated
10/19/2022
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