Englewood Dermatology Center

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

207N00000X Issued in NJ

Legal business name

ENGLEWOOD DERMATOLOGY CENTER

Practice address

300 Grand Ave
Suite 201
Englewood, NJ 07631-4398

Phone

(201) 569-5151

Fax

(201) 569-9193

NPI assigned

Mar 22, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Lenis Gonzalez, M.D.

Title

M.D.

Phone

(201) 569-5151

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1588930663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GRAND AVE",
            "address_2": "SUITE 201",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314398",
            "telephone_number": "201-569-5151",
            "fax_number": "201-569-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GRAND AVE",
            "address_2": "SUITE 201",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314398",
            "telephone_number": "201-569-5151",
            "fax_number": "201-569-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGLEWOOD DERMATOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LENIS",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "201-569-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": "207N00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1316145329",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Englewood City Public Schools
• Englewood Dental Arts LLC
• Englewood Dental, PA
• Englewood Dental, PA
• Englewood Dentist LLC
• Englewood Dermatology Center (Lenis Gonzalez, M.D.)
• Englewood Ear Nose & Throat PC
• Englewood Eye Associates P.a. (Englewood Eye Associates)
• Englewood Eye Center, LLC
• Englewood Eye Center, LLC

• Preferred Provider Organization in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Preferred Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.