Organization Active NPI

Academy Dermatology and Cosmetic Center, PA

  • Dermatology Physician
  • Moorestown, NJ
National Provider Identifier
1104991173
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ACADEMY DERMATOLOGY AND COSMETIC CENTER, PA
Practice address
110 Marter Ave
Suite 306
Moorestown, NJ 08057-3124
Phone
(856) 642-6450
Fax
(856) 642-6451
NPI assigned
Nov 22, 2006
Last updated
Apr 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Authorized official

Name
Dr. Magaly Patricia Del Monaco, D.O.
Title
Medical Director
Phone
(856) 642-6450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

110 Marter Ave
Suite 306
Moorestown, NJ 08057-3124

Mailing address

110 Marter Ave
Suite 306
Moorestown, NJ 08057-3124
Phone (856) 642-6450

National Provider Directory

National Provider Directory

Locations

110 Marter Ave
Ste 306
Moorestown, NJ 08057
Phone (856) 642-6450

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1104991173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MARTER AVE",
            "address_2": "SUITE 306",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573124",
            "telephone_number": "856-642-6450",
            "fax_number": "856-642-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MARTER AVE",
            "address_2": "SUITE 306",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573124",
            "telephone_number": "856-642-6450",
            "fax_number": "856-642-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY DERMATOLOGY AND COSMETIC CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "DEL MONACO",
        "authorized_official_first_name": "MAGALY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "856-642-6450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.