Advanced Dermatology and Skin Cancer Center

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ADVANCED DERMATOLOGY AND SKIN CANCER CENTER

Practice address

987 Boardman Canfield Rd
Boardman, OH 44512-4222

Phone

(330) 965-8760

Fax

(330) 965-9325

NPI assigned

Jul 7, 2011

Last updated

Oct 20, 2011By 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

Mrs. Vicki Groner

Title

Billing Manager

Phone

(330) 965-8760

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1710274014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124222",
            "telephone_number": "330-965-8760",
            "fax_number": "330-965-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124222",
            "telephone_number": "330-965-8760",
            "fax_number": "330-965-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY AND SKIN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "GRONER",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "330-965-8760",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Cardiocare Inc
• Advanced Chiropractic & Rehab, Inc.
• Advanced Chiropractic and Physical Therapy LLC
• Advanced Chiropractic and Rahabilitation, LLC
• Advanced Dermatology and Skin Cancer Center
• Advanced Foot and Ankle Centers, Inc
• Advanced Motion X-Ray
• Advanced Women's Care Inc
• Agape Behavioral Health Center
• Nicholas Frank Agnesi, M.D.

• Clinical Medical Laboratory in Boardman, OH
• Providers in Boardman, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.