Cornerstone Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD055106L Issued in PA

Legal business name

CORNERSTONE DERMATOLOGY, PC

Practice address

923 Russell Dr
Lebanon, PA 17042-7487

Phone

(717) 270-9004

Fax

(717) 270-1677

NPI assigned

Mar 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daniel G Zavadak, MDNPI 1598745747

Title

President

Phone

(717) 270-9004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 2

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

• Daniel G Zavadak, M.D.

  • Dermatology Physician
  • Lebanon, PA
  • NPI 1598745747
  Medicare reassignment Care Compare group NPD Authorized official
• Vasudha L Patel, PA-C

  • Medical Physician Assistant
  • Lebanon, PA
  • NPI 1023986106
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1982736385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 RUSSELL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427487",
            "telephone_number": "717-270-9004",
            "fax_number": "717-270-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 RUSSELL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427487",
            "telephone_number": "717-270-9004",
            "fax_number": "717-270-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "ZAVADAK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-270-9004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD055106L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna M Corbett, MSW
• William Alexander Corbett II, MS, RDN, LDN
• Lauren Elizabeth Corbitt
• Amber Shey Cornell, LSW
• Cornerstone Caregiving East LLC
• Sarah K Cornman, MT-BC
• Cornwall Family Dentistry, LLC
• Cornwall-Lebanon School District
• Carolina Correa, M.D., M.P.H.
• Michael Andrew Cotarla, D.O.

• Dermatology Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.