Advanced Dermatology & Skin Surgery, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

25MA07911600 Issued in NJ

Legal business name

ADVANCED DERMATOLOGY & SKIN SURGERY, PC

Practice address

886 River Ave
Lakewood, NJ 08701-5220

Phone

(732) 905-9200

NPI assigned

Jun 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mordechai M Tarlow, M.D.NPI 1992762017

Title

President

Phone

(732) 905-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ICICAA

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mordechai M Tarlow, M.D.

  • Dermatology Physician
  • Lakewood, NJ
  • NPI 1992762017
  Medicare reassignment Care Compare group NPD Authorized official
• Aviva Drillick, APN

  • Nurse Practitioner
  • Lakewood, NJ
  • NPI 1760100895
  Medicare reassignment Care Compare group NPD
• Esther Stern, NP-C, RN

  • Nurse Practitioner
  • Lakewood, NJ
  • NPI 1104150846
  Medicare reassignment Care Compare group NPD
• Pesha Miriam Cohen

  • Nurse Practitioner
  • Lakewood, NJ
  • NPI 1932650405
  Medicare reassignment NPD
• Yocheved Fay Prag, APN

  • Nurse Practitioner
  • Lakewood, NJ
  • NPI 1063999605
  Medicare reassignment NPD
• Adena Tara Homnick, RPA-C

  • Physician Assistant
  • Newark, NJ
  • NPI 1467661140
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1023044724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015220",
            "telephone_number": "732-905-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015220",
            "telephone_number": "732-905-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY & SKIN SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "TARLOW",
        "authorized_official_first_name": "MORDECHAI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-905-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA07911600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Admire ABA LLC
• Raizl Adolf, BCBA
• Linda Evette Adorno
• Advance Medical Services, LLC.
• Advanced Anesthesia LLC
• Advanced Hearing Center LLC
• Advanced Mobile Eye Care Professional Service Corporation
• Advanced Pediatric Therapy
• Advanced Pediatric Therapy Services LLC
• Advanced Therapy Solutions LLC

• Dermatology Physician in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.