Organization
IMAR DERM PATH LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMI GEFFNER MD (OWNER)
(732) 456-7777
Entity
Organization
Contact information
Practice address
540 LACEY RD STE 2A, FORKED RIVER, NJ 08731-1532
(732) 456-7777
(848) 251-2189
Mailing address
1580 LAKEWOOD RD STE 16, TOMS RIVER, NJ 08755-3287
(732) 456-7777
(848) 251-2189
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
25MA03772900
NJ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA09002600
NJ
Other
Enumeration date
12/04/2017
Last updated
01/16/2018
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