Dermatology & Advanced Skin Care, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

H0077765 Issued in MD

Legal business name

DERMATOLOGY & ADVANCED SKIN CARE, INC.

Practice address

6021 University Blvd
Ste 390
Ellicott City, MD 21043-6077

Phone

(410) 203-0607

NPI assigned

Dec 23, 2014

Organization subpart

No

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

Authorized official

Name

Donna Mashburn

Title

Office Manager

Phone

(410) 203-0607

Specialties & licenses 1

Addresses

Practitioners 1

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

• Paul Andrew Rusonis, M.D.

  • Dermatology Physician
  • Ellicott City, MD
  • NPI 1922077171
  NPD (past)

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1962890186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6021 UNIVERSITY BLVD",
            "address_2": "STE 390",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436077",
            "telephone_number": "410-203-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 UNIVERSITY BLVD",
            "address_2": "STE 390",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436077",
            "telephone_number": "410-203-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & ADVANCED SKIN CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "MASHBURN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-203-0607"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "H0077765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert J Denmark, LCPC
• Ruth Prendergast Dennison-Tedesco, PHD
• Roxanne Depietro-Hartman, OTR/L
• Mitra Derakhshan, DDS MS
• Dermatology & Advanced Skin Care
• Helen E. Derossi, LCSW-C
• Chetna Kartik Desai, D.D.S.
• Kartik J Desai, MD
• Rupal R Desai, M.D.
• Ujwala Vivek Desai, MD

• Dermatology Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.