Dermatology Associates, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MA20461 Issued in NJ

Legal business name

DERMATOLOGY ASSOCIATES, PA

Practice address

303 Chester Ave
Moorestown, NJ 08057-2525

Phone

(856) 235-1178

Fax

(856) 722-9244

NPI assigned

Apr 26, 2006

Last updated

Feb 12, 2013By 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

Dr. Peter Johann Koblenzer, MD

Title

President

Phone

(856) 235-1178

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1932166774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CHESTER AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572525",
            "telephone_number": "856-235-1178",
            "fax_number": "856-722-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CHESTER AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572525",
            "telephone_number": "856-235-1178",
            "fax_number": "856-722-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "KOBLENZER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JOHANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-235-1178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA20461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles A Dennis, MD
• Alan D. Dennison, MD
• Dental Associates of Moorestown
• Dental Professionals of Moorestown LLC
• Margaret Antonia Deoliveira, M.D
• Amisha Desai, OD
• Khusbu Desai
• Nipa S Desai, RPH
• Albert Desiderio, PT, DPT
• Phyllis Horning Detwiler, DMD

• Dermatology Physician in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.