NPIMap

Organization Active NPI

South Jersey Skin Care & Laser Center, P.C.

  • Dermatology Physician
  • Marlton, NJ
National Provider Identifier
1518906403
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA06657000 Issued in NJ
Legal business name
SOUTH JERSEY SKIN CARE & LASER CENTER, P.C.
Practice address
127 Church Rd
Suite 100
Marlton, NJ 08053-9402
Phone
(856) 810-9888
Fax
(856) 810-9889
NPI assigned
Jun 6, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robin Merle Levin, M.D.NPI 1659327211
Title
President
Phone
(856) 810-9888

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 Physician 207N00000X 25MA06657000 NJ Primary

Addresses

Primary practice location

127 Church Rd
Suite 100
Marlton, NJ 08053-9402

Mailing address

127 Church Rd
Suite 100
Marlton, NJ 08053-9402
Phone (856) 810-9888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116000058 NJ Part B Supplier - Clinic/Group Practice 2567426919 Receives reassigned benefits from 8 practitioners
Practice locations: Hammonton, NJ; Mount Laurel, NJ

National Provider Directory

National Provider Directory

Locations

856 S White Horse Pike
Ste 6
Hammonton, NJ 08037
Phone (609) 567-1700

127 Church Rd
Ste 100
Marlton, NJ 08053
Phone (856) 345-2240

101 Gaither Dr
Mount Laurel, NJ 08054
Phone (856) 810-9888

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518906403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CHURCH RD",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539402",
            "telephone_number": "856-810-9888",
            "fax_number": "856-810-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CHURCH RD",
            "address_2": "SUITE 100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539402",
            "telephone_number": "856-810-9888",
            "fax_number": "856-810-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY SKIN CARE & LASER CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "MERLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-810-9888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA06657000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.