Shore Dermatology LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

25MB07615100 Issued in NJ

Legal business name

SHORE DERMATOLOGY LLC

Practice address

9 Professional Circle
Suite 103
Colts Neck, NJ 07722

Phone

(732) 462-5200

Fax

(732) 462-5212

NPI assigned

Jan 9, 2008

Last updated

Sep 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Risa Jill Gorin, DO

Title

Sole Member

Phone

(732) 462-5200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1629253513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL CIRCLE",
            "address_2": "SUITE 103",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "07722",
            "telephone_number": "732-462-5200",
            "fax_number": "732-462-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL CIRCLE",
            "address_2": "SUITE 103",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "07722",
            "telephone_number": "732-462-5200",
            "fax_number": "732-462-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "GORIN",
        "authorized_official_first_name": "RISA",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "732-462-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MB07615100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Scianni, D.M.D.
• Sheridan Radiology Services of Central FL, Inc.
• Sheridan Radiology Services of Pinellas, Inc.
• Elaine Shor, LPC, ATR-BC
• Shore Dental Sleep Care
• Shore Sleep and Wellness LLC
• Shore Sleep Solutions LLC
• Bryan Allan Shumaker, DDS
• Sllccninc.
• Shannon P Smith, LSW, LCADC

• Medical Specialty Clinic/Center in Colts Neck, NJ
• Providers in Colts Neck, NJ by specialty
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.