Organization
ASSOCIATES IN DERMATOLOGY AND COSMETIC SURGERY THE MILLBURN LASER CENT
Active
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
Update your record
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