Center for Dermatology and Skin Surgery LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CENTER FOR DERMATOLOGY AND SKIN SURGERY LLC

Practice address

1 W Ridgewood Ave
Suite 103
Paramus, NJ 07652-2359

Phone

(201) 385-1452

NPI assigned

Oct 26, 2009

Organization subpart

No

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

Authorized official

Name

Michael WiederkehrNPI 1396759783

Title

Medical Doctor/Owner

Phone

(201) 857-4200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 15

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

• Michael Wiederkehr, MD

  • Dermatology Physician
  • Paramus, NJ
  • NPI 1396759783
  Medicare reassignment Care Compare group NPD Authorized official
• David Folk, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Paramus, NJ
  • NPI 1417215971
  Medicare reassignment Care Compare group NPD
• Carmen J Garcia, MD

  • Dermatology Physician
  • Paramus, NJ
  • NPI 1639105331
  Medicare reassignment Care Compare group NPD
• Eduard Raklyar, M.D.

  • Dermatology Physician
  • Rutherford, NJ
  • NPI 1790906006
  Medicare reassignment Care Compare group NPD
• Rachel Sacknovitz, FNP-C

  • Family Nurse Practitioner
  • Paramus, NJ
  • NPI 1790467025

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Justin Wong, PA-C

  • Physician Assistant
  • Freehold, NJ
  • NPI 1578321618
  Medicare reassignment Care Compare group NPD
• Xuan Wang, M.D. PH.D.

  • Anatomic Pathology Physician
  • Woodbury, NY
  • NPI 1578706032

  NJ

  Medicare reassignment Care Compare group NPD
• Miriam Fox

  • Physician Assistant
  • West Orange, NJ
  • NPI 1962885301
  Medicare reassignment Care Compare group
• Lisa M Micik, PA-C

  • Physician Assistant
  • Paramus, NJ
  • NPI 1003826157
  Medicare reassignment Care Compare group
• Ariella Rosenfeld, PA

  • Physician Assistant
  • Paramus, NJ
  • NPI 1225734221
  Medicare reassignment Care Compare group
• Janine J. Zolty, PA

  • Physician Assistant
  • West Paterson, NJ
  • NPI 1023265790
  Medicare reassignment Care Compare group
• David Hermogenes Ciocon, M.D.

  • MOHS-Micrographic Surgery Physician
  • Hackensack, NJ
  • NPI 1790878866

  Dermatology

  Medicare reassignment NPD

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1194051243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE STE 103",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522359",
            "telephone_number": "201-385-1452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 River St Ste 4A",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070305619",
            "country_code": "US",
            "telephone_number": "201-857-4200",
            "fax_number": "201-857-4199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 Brook Ave Ste B108",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070553357",
            "country_code": "US",
            "telephone_number": "201-857-4200",
            "fax_number": "201-857-4199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR DERMATOLOGY AND SKIN SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "WIEDERKEHR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/OWNER",
        "authorized_official_telephone_number": "201-857-4200"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurashley Castillo
• Giuseppe Castronovo
• Catch-a-Ride of NJ
• Estefanie Ceballo, LMHC, LPC, NCC, ACS
• Center for Cosmetic and Reconstructive Surgery
• Center for Family Support, New Jersey, Inc
• Center for Integrative and Traditional Medicine LLC
• Center for Neurofeedback and Integrative Health
• Center for Plastic & Reconstructive Surgery PA
• Century Medical Group, LLC

• Dermatology Physician in Paramus, NJ
• Providers in Paramus, 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 Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.