NPIMap

Organization Active NPI

New Jersey Dermatology and Aesthetics Center LLC

  • Dermatology Physician
  • Marlboro, NJ
National Provider Identifier
1780178871
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NEW JERSEY DERMATOLOGY AND AESTHETICS CENTER LLC
Practice address
479 County Road 520 Ste A201
Marlboro, NJ 07746-1087
Phone
(732) 702-1212
Fax
(732) 702-1214
NPI assigned
Jun 21, 2018
Last updated
Apr 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Authorized official

Name
Zain Husain, MDNPI 1225325848
Title
Owner
Phone
(732) 702-1212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary
MOHS-Micrographic Surgery Physician 207ND0101X

Addresses

Primary practice location

479 County Road 520 Ste A201
Marlboro, NJ 07746-1087

Mailing address

479 County Road 520 Ste A201
Marlboro, NJ 07746-1087
Phone (732) 702-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180823002160 NJ Part B Supplier - Clinic/Group Practice 3678822608 Receives reassigned benefits from 13 practitioners
Practice locations: Marlboro, NJ; Englewood, NJ; Clifton, NJ

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
31D2163236New Jersey Dermatology479 County Rd 520 E, Marlboro, NJ 07746ComplianceAug 5, 2027

National Provider Directory

National Provider Directory

Locations

479 County Road 520
Ste 201
Marlboro, NJ 07746

479 County Road 520
Ste A201
Marlboro, NJ 07746
Phone (732) 702-1212

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1780178871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 COUNTY ROAD 520 STE A201",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461087",
            "telephone_number": "732-702-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 COUNTY ROAD 520 STE A201",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461087",
            "telephone_number": "732-702-1212",
            "fax_number": "732-702-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY DERMATOLOGY AND AESTHETICS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "HUSAIN",
        "authorized_official_first_name": "ZAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-702-1212",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.