Organization Active NPI

Dermacraft LLC

  • Family Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1669199402
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DERMACRAFT LLC
Practice address
144 Coles Way
Lakewood, NJ 08701-4885
Phone
(845) 901-7289
Fax
(505) 416-4819
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Elysse Lerner, APN
Title
Owner
Phone
(845) 901-7289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

144 Coles Way
Lakewood, NJ 08701-4885

Mailing address

144 Coles Way
Lakewood, NJ 08701-4885
Phone (845) 901-7289

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1669199402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 COLES WAY",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014885",
            "telephone_number": "845-901-7289",
            "fax_number": "505-416-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 COLES WAY",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014885",
            "telephone_number": "845-901-7289",
            "fax_number": "505-416-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMACRAFT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "LERNER",
        "authorized_official_first_name": "ELYSSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-901-7289",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.