Organization
THE DERMATOLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SWARNA PRIYA SIVANESAN M.D (OWNER)
(650) 274-5513
Entity
Organization
Contact information
Practice address
2315 ROUTE 34, MANASQUAN, NJ 08736-1444
(650) 274-5513
Mailing address
PO BOX 330, HAZLET, NJ 07730-0330
(650) 274-5513
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2013
Last updated
07/16/2013
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