Family Dermatology of New Jersey PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FAMILY DERMATOLOGY OF NEW JERSEY PC

Practice address

901 W Main St
Suite 201
Freehold, NJ 07728-2537

Phone

(732) 637-9982

Fax

(215) 383-0114

NPI assigned

Oct 13, 2010

Organization subpart

No

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

Authorized official

Name

Paula M. Nelson, MD

Title

Owner

Phone

(732) 637-9982

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1164732095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MORRIS AVE",
            "address_2": "SUITE 150",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103300",
            "telephone_number": "215-519-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "SUITE 201",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-637-9982",
            "fax_number": "215-383-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DERMATOLOGY OF NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-637-9982",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Freehold, NJ
• Providers in Freehold, 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 May 2, 2012; 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.