Umdnj RWJ Pediatric Dermatology

Primary specialty

Pediatric Dermatology PhysicianTaxonomy code 207NP0225X

Legal business name

UMDNJ RWJ PEDIATRIC DERMATOLOGY

Practice address

89 French Street
Suite 2300 Childrens Health Institute of New Jersey
New Brunswick, NJ 08901

Phone

(732) 235-6625

Fax

(732) 235-5002

NPI assigned

Feb 21, 2007

Last updated

Jan 11, 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

Carole Penzynski

Title

Credentialing Manager

Phone

(732) 212-0051

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1710022132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 FRENCH STREET",
            "address_2": "SUITE 2300 CHILDRENS HEALTH INSTITUTE OF NEW JERSEY",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-235-6625",
            "fax_number": "732-235-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMDNJ RWJ PEDIATRIC DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "PENZYNSKI",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "732-212-0051"
    },
    "taxonomies": [
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dermatology Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Pediatric Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.