Organization Active NPI

Wellness Dermatology LLC

  • Dermatology Physician
  • Lawrenceville, NJ
National Provider Identifier
1477031318
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
WELLNESS DERMATOLOGY LLC
Practice address
638 Lawrenceville Rd
Lawrenceville, NJ 08648-4208
Phone
(609) 337-7643
Fax
(609) 337-7648
NPI assigned
Aug 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Dr. Erine Allison Kupetsky, D.O.NPI 1952400012
Title
Owner, Member
Phone
(609) 947-3786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

638 Lawrenceville Rd
Lawrenceville, NJ 08648-4208

Mailing address

638 Lawrenceville Rd
Lawrenceville, NJ 08648-4208
Phone (609) 337-7643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181018001143 NJ Part B Supplier - Clinic/Group Practice 3971855065 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrenceville, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1477031318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 LAWRENCEVILLE RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086484208",
            "telephone_number": "609-337-7643",
            "fax_number": "609-337-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 LAWRENCEVILLE RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086484208",
            "telephone_number": "609-337-7643",
            "fax_number": "609-337-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "KUPETSKY",
        "authorized_official_first_name": "ERINE",
        "authorized_official_middle_name": "ALLISON",
        "authorized_official_title_or_position": "OWNER, MEMBER",
        "authorized_official_telephone_number": "609-947-3786",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.