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

LicenseStateTypeSpecialty
A51591CAMDDermatology Physician
MA 51201NJMDDermatology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Wallington, NJ

All providers in Wallington, NJ · Dermatology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.