Organization
ENGLEWOOD DERMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LENIS GONZALEZ M.D. (M.D.)
(201) 569-5151
Entity
Organization
Contact information
Practice address
300 GRAND AVE, SUITE 201, ENGLEWOOD, NJ 07631-4398
(201) 569-5151
(201) 569-9193
Mailing address
300 GRAND AVE, SUITE 201, ENGLEWOOD, NJ 07631-4398
(201) 569-5151
(201) 569-9193
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
207N00000X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316145329
INDIVIDUAL NPI
—
Enumeration date
03/22/2012
Last updated
03/22/2012
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