Organization
COASTAL DERMATOLOGY LLC
Active
Organization
COASTAL DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANITA MARIE OSMUNDSON D.O. (DOCTOR)
(732) 836-1600
Entity
Organization
Contact information
Practice address
198 JACK MARTIN BLVD., BRICK, NJ 08724
(732) 836-1600
(732) 836-1601
Mailing address
198 JACK MARTIN BLVD., BRICK, NJ 08724
(732) 836-1600
(732) 836-1601
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
12/17/2014
Last updated
01/30/2015
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