New Age Dermatology Center PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2000-00747 Issued in NC

Legal business name

NEW AGE DERMATOLOGY CENTER PA

Practice address

1091 Pemberton Hill Rd Ste 201
Apex, NC 27502-4269

Phone

(919) 367-3625

Fax

(919) 367-3608

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Micsunica Elvira Chiritescu, MD

Title

Physician Owner

Phone

(919) 624-2802

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Diana Chiritescu

  • Physician Assistant
  • Apex, NC
  • NPI 1346123718
  NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1609927623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 PEMBERTON HILL RD STE 201",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024269",
            "telephone_number": "919-367-3625",
            "fax_number": "919-367-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 PEMBERTON HILL RD STE 201",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024269",
            "telephone_number": "919-367-3625",
            "fax_number": "919-367-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW AGE DERMATOLOGY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "CHIRITESCU",
        "authorized_official_first_name": "MICSUNICA ELVIRA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "919-624-2802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2000-00747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "129ER",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129ER",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Apex, NC
• Providers in Apex, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.