Camila Krysicka Janniger, M.D.
Individual provider Active NPI Dermatology Physician · Wallington, NJ
NPI 1659499010 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1659499010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- MA 51201 (NJ)
- Practice address
- 42 Locust Ave
Wallington, NJ 07057-1300 - Phone
- (973) 472-5044
- Fax
- (973) 472-4235
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A51591 | CA | MD | Dermatology Physician |
| MA 51201 | NJ | MD | Dermatology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MA 51201 | NJ | Yes |
| Dermatology Physician | 207N00000X | A51591 | CA |
Addresses
Primary practice location
42 Locust Ave
Wallington, NJ 07057-1300
Mailing address
100 Glenwood Rd
Englewood, NJ 07631-1951
Phone (201) 569-0046
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All providers in Wallington, NJ · Dermatology Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.