A & a Dermatology Associate PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

25MA03230500 Issued in NJ

Legal business name

A & A DERMATOLOGY ASSOCIATE PA

Practice address

1176 Karin St
Vineland, NJ 08360-4209

Phone

(856) 691-1737

NPI assigned

Nov 13, 2013

Organization subpart

No

Name

L. Robert Smith, M.D.

Title

Owner

Phone

(856) 691-1737

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 27, 2014.

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1770913634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 KARIN ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604209",
            "telephone_number": "856-691-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 KARIN ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604209",
            "telephone_number": "856-691-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A & A DERMATOLOGY ASSOCIATE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-13",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "L.",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-691-1737",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MA03230500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN",
            "identifier": "060850",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Vineland, NJ
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.