Organization
A & A DERMATOLOGY ASSOCIATE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
L. ROBERT SMITH M.D. (OWNER)
(856) 691-1737
Entity
Organization
Contact information
Practice address
1176 KARIN ST, VINELAND, NJ 08360-4209
(856) 691-1737
Mailing address
1176 KARIN ST, VINELAND, NJ 08360-4209
(856) 691-1737
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
25MA03230500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060850
MEDICARE P-TAN
NJ
Enumeration date
11/13/2013
Last updated
03/27/2014
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