Albuquerque Center for Dermatology, PA

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

67-57 Issued in NM

Legal business name

ALBUQUERQUE CENTER FOR DERMATOLOGY, PA

Practice address

8100 Constitution PL NE
Suite 310
Albuquerque, NM 87110-7643

Phone

(505) 293-5333

Fax

(505) 293-5334

NPI assigned

Oct 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Vincent A Muscarella, M.D.

Title

President

Phone

(505) 293-5333

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• ABQ Center for Dermatology Other name

Locations

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

{
    "created_epoch": "1160265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1982791109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 CONSTITUTION PL NE",
            "address_2": "SUITE 310",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107643",
            "telephone_number": "505-293-5333",
            "fax_number": "505-293-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 CONSTITUTION PL NE",
            "address_2": "SUITE 310",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107643",
            "telephone_number": "505-293-5333",
            "fax_number": "505-293-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBUQUERQUE CENTER FOR DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-08",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "MUSCARELLA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-293-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NM",
            "license": "67-57",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NM",
            "license": "67-57",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "NM",
            "license": "67-57",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NM",
            "license": "67-57",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NM",
            "license": "67-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20107",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABQ Center for Dermatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Procedural Dermatology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Procedural Dermatology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.