Medical Laser Skin Care Center of New Jersey LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25MB05655300 Issued in NJ

Legal business name

MEDICAL LASER SKIN CARE CENTER OF NEW JERSEY LLC

Practice address

465 Cranbury Rd Ste 203
East Brunswick, NJ 08816-7600

Phone

(732) 254-6400

NPI assigned

Nov 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. David M. Zeidwerg, D.O.

Title

Sole Member/President

Phone

(732) 254-6400

Specialties & licenses 1

Addresses

Other names 1

• David M. Zeidwerg, D.O., LLC Doing business as

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1114228871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 CRANBURY RD STE 203",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088167600",
            "telephone_number": "732-254-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 CRANBURY RD STE 203",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088167600",
            "telephone_number": "732-254-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LASER SKIN CARE CENTER OF NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-12",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "ZEIDWERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "SOLE MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "732-254-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MB05655300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David M. Zeidwerg, D.O., LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Neurology Physician in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.