NPIMap

Organization Active NPI

Dermatology Physicians of South Jersey, PA

  • Dermatopathology Physician
  • Mount Laurel, NJ
National Provider Identifier
1124185004
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
Legal business name
DERMATOLOGY PHYSICIANS OF SOUTH JERSEY, PA
Practice address
150 Century Pkwy Ste 105
Mount Laurel, NJ 08054-1129
Phone
(856) 206-0201
NPI assigned
Jan 2, 2007
Organization subpart
Yes
Parent organization
DERMATOLOGY ASSOCIATES OF SOUTH JERSEY, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Authorized official

Name
Joseph Anthony Velez
Title
Manager
Phone
(856) 546-8672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0900X NJ Primary

Addresses

Primary practice location

150 Century Pkwy Ste 105
Mount Laurel, NJ 08054-1129

Mailing address

112 White Horse Pike
RT. 30
Haddon Heights, NJ 08035-1908
Phone (856) 546-8672

Other practice location 1

112 White Horse Pike
Rt. 30
Haddon Heights, NJ 08035-1908
Phone (856) 546-8672

National Provider Directory

National Provider Directory

Locations

112 White Horse Pike
#30
Haddon Hgts, NJ 08035
Phone (856) 546-5353

150 Century Pkwy
Ste 105
Mount Laurel, NJ 08054
Phone (856) 206-0201

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1124185004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WHITE HORSE PIKE",
            "address_2": "RT. 30",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351908",
            "telephone_number": "856-546-8672",
            "fax_number": "856-546-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CENTURY PKWY STE 105",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541129",
            "telephone_number": "856-206-0201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 White Horse Pike",
            "address_2": "Rt. 30",
            "address_purpose": "LOCATION",
            "city": "Haddon Heights",
            "state": "NJ",
            "postal_code": "080351908",
            "country_code": "US",
            "telephone_number": "856-546-8672",
            "fax_number": "856-546-5315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY PHYSICIANS OF SOUTH JERSEY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DERMATOLOGY ASSOCIATES OF SOUTH JERSEY, LLC.",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "VELEZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "856-546-8672"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.