Imar Derm Path Laboratory LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA09002600 Issued in NJ

Legal business name

IMAR DERM PATH LABORATORY LLC

Practice address

540 Lacey Rd Ste 2a
Forked River, NJ 08731-1532

Phone

(732) 456-7777

Fax

(848) 251-2189

NPI assigned

Dec 4, 2017

Last updated

Jan 16, 2018By 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. Rami Geffner, MDNPI 1366491110

Title

Owner

Phone

(732) 456-7777

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rami E Geffner, MD

  • Dermatology Physician
  • Neptune, NJ
  • NPI 1366491110
  Authorized official Same address or phone

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1689189300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 LAKEWOOD RD STE 16",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087553287",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 LACEY RD STE 2A",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087311532",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAR DERM PATH LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "GEFFNER",
        "authorized_official_first_name": "RAMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-456-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NJ",
            "license": "25MA03772900",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA09002600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tim Huang
• Stephen Hulett, LMSW
• Sajjad Hussain, MEDICAL DOCTOR
• Jedediah P Hyle
• Anna Ictchenko, PMHNP-BC
• Travis John Impellizzeri, DC
• Valerie Inzinna, CD(DONA)
• Nichole Isgro, DC
• Calaise Jackson
• Joel Peter Jannone, MD

• Anatomic Pathology & Clinical Pathology Physician in Forked River, NJ
• Providers in Forked River, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.