NPIMap

Organization Active NPI

Associates in Dermatology and Cosmetic Surgery the Millburn Laser Cent

  • Dermatology Physician
  • Millburn, NJ
National Provider Identifier
1487770905
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MC68842 Issued in NJ
Legal business name
ASSOCIATES IN DERMATOLOGY AND COSMETIC SURGERY THE MILLBURN LASER CENT
Practice address
12 E Willow St
Millburn, NJ 07041-1417
Phone
(973) 376-8500
Fax
(973) 376-1820
NPI assigned
Mar 22, 2007
Last updated
Oct 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Authorized official

Name
Eric Scott Siegel, MDNPI 1275578262
Title
Owner
Phone
(973) 376-8500

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 MC68842 NJ Primary

Addresses

Primary practice location

12 E Willow St
Millburn, NJ 07041-1417

Mailing address

12 East Willow Street
Millburn, NJ 07041-1737
Phone (973) 376-8500

National Provider Directory

National Provider Directory

Locations

140 Sylvan Ave
Ste 302
Englewood Cliffs, NJ 07632
Phone (201) 568-8400

370 Summit Ave
Hackensack, NJ 07601
Phone (201) 525-0057

12 E Willow St
#8174
Millburn, NJ 07041

350 Springfield Ave
Ste 205
Summit, NJ 07901

750 Lexington Ave
Ste 2301
New York, NY 10022

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1487770905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EAST WILLOW STREET",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411737",
            "telephone_number": "973-376-8500",
            "fax_number": "973-376-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E WILLOW ST",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411417",
            "telephone_number": "973-376-8500",
            "fax_number": "973-376-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN DERMATOLOGY AND COSMETIC SURGERY THE MILLBURN LASER CENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-376-8500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MC68842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.