NPIMap

Organization Active NPI

Laser Surgery and Cosmetic Dermatology Centers Inc

Doing business as Main Line Center for Laser Surgery

  • Dermatology Physician
  • Ardmore, PA
National Provider Identifier
1750666566
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD045790L Issued in PA
Legal business name
LASER SURGERY AND COSMETIC DERMATOLOGY CENTERS INC
Doing business as
Main Line Center for Laser Surgery
Practice address
32 Parking PLZ
Suite 200
Ardmore, PA 19003-2415
Phone
(610) 645-5551
Fax
(610) 645-5151
NPI assigned
Oct 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Dr. Eric F. Bernstein, M.D.NPI 1336183383
Title
Medical Director
Phone
(610) 645-5551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X MD045790L PA Primary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X MD432401 PA

Addresses

Primary practice location

32 Parking PLZ
Suite 200
Ardmore, PA 19003-2415

Mailing address

32 Parking PLZ
Suite 200
Ardmore, PA 19003-2415
Phone (610) 645-5551

Other names 1

  • Main Line Center for Laser Surgery Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2259753Main Line Center for Laser Surgery32 Parking Plaza, Ardmore, PA 19003Certificate of waiverMay 10, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

931 E Haverford Rd
Fl 2
Bryn Mawr, PA 19010
Phone (610) 527-0102

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1750666566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PARKING PLZ",
            "address_2": "SUITE 200",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032415",
            "telephone_number": "610-645-5551",
            "fax_number": "610-645-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 PARKING PLZ",
            "address_2": "SUITE 200",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032415",
            "telephone_number": "610-645-5551",
            "fax_number": "610-645-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER SURGERY AND COSMETIC DERMATOLOGY CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "610-645-5551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD045790L",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD432401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Line Center for Laser Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ardmore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.