Center for Dermatologic Care, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MA050827 Issued in NJ

Legal business name

CENTER FOR DERMATOLOGIC CARE, LLC

Practice address

170 Avenue at the Common
Suite 2
Shrewsbury, NJ 07702-4803

Phone

(732) 542-6300

Fax

(732) 542-6392

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Forrest P Resnikoff, MD

Title

President

Phone

(732) 542-6300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1942401070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 AVENUE AT THE COMMON",
            "address_2": "SUITE 2",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024803",
            "telephone_number": "732-542-6300",
            "fax_number": "732-542-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 AVENUE AT THE COMMON",
            "address_2": "SUITE 2",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024803",
            "telephone_number": "732-542-6300",
            "fax_number": "732-542-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DERMATOLOGIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "RESNIKOFF",
        "authorized_official_first_name": "FORREST",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-542-6300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA050827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.