NPIMap

Organization Active NPI

Skin Laser and Surgery Specialists of Ny/NJ, LLC

  • MOHS-Micrographic Surgery Physician
  • Hackensack, NJ
National Provider Identifier
1538100987
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
SKIN LASER AND SURGERY SPECIALISTS OF NY/NJ, LLC
Practice address
20 Prospect Ave
Suite 702
Hackensack, NJ 07601
Phone
(201) 441-9890
Fax
(201) 441-9893
NPI assigned
Jun 9, 2006
Last updated
Jun 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Authorized official

Name
Dr. David J Goldberg, MDNPI 1528001583
Title
Director/Owner
Phone
(201) 594-9901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X Primary

Addresses

Primary practice location

20 Prospect Ave
Suite 702
Hackensack, NJ 07601

Mailing address

20 Prospect Ave
Suite 702
Hackensack, NJ 07601-1997
Phone (201) 441-9890

Other practice location 1

20 Prospect Ave
Suite 702
Hackensack, NJ 07601-1997
Phone (201) 441-9890

National Provider Directory

National Provider Directory

Locations

105 Raider Blvd
Ste 203
Hillsborough, NJ 08844
Phone (201) 444-9890

250 Old Hook Rd
Fl 3
Westwood, NJ 07675
Phone (201) 594-9901

115 E 57th St
Rm 710
New York, NY 10022
Phone (212) 750-8900

Practitioners & affiliated clinicians

Practitioners 3

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": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529625600000",
    "number": "1538100987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 702",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "201-441-9890",
            "fax_number": "201-441-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "address_2": "SUITE 702",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-441-9890",
            "fax_number": "201-441-9893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Prospect Ave",
            "address_2": "Suite 702",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011997",
            "country_code": "US",
            "telephone_number": "201-441-9890",
            "fax_number": "201-441-9893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SKIN LASER AND SURGERY SPECIALISTS OF NY/NJ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2018-06-22",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "201-594-9901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.