Organization
DERMATOLOGY AND LASER CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN COHEN MD (OWNER)
(732) 222-8323
Entity
Organization
Contact information
Practice address
279 THIRD AVENUE, SUITE 603, LONG BRANCH, NJ 07740-6205
(732) 222-8323
(732) 870-9488
Mailing address
PO BOX 18751, NEWARK, NJ 07191-8751
(732) 222-8323
(732) 870-9488
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
25MA06221000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0675790000
AMERIHEALTH
NJ
Enumeration date
05/23/2007
Last updated
03/07/2016
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