Organization
DERMATOLOGY CENTER OF WASHINGTON TOWNSHIP PC
Active
Organization
DERMATOLOGY CENTER OF WASHINGTON TOWNSHIP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN M WINTER MD (PHYSICIAN PRESIDENT)
(856) 589-3331
Entity
Organization
Contact information
Practice address
100 KINGS WAY E STE A3, WASHINGTON PAVILIONS, SEWELL, NJ 08080-2237
(856) 589-3331
(856) 589-3416
Mailing address
100 KINGS WAY E STE A3, WASHINGTON PAVILIONS, SEWELL, NJ 08080-2237
(856) 589-3331
(856) 589-3416
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0112030000
IBC
—
01
—
2423791
AETNA
—
01
—
CJ2498
RR MEDICARE
NJ
Enumeration date
10/06/2006
Last updated
03/17/2015
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