Basic Information
| Provider Information | |||||||||
| NPI: | 1790082535 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABOVE ALL DERMATOLOGY DELAWARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2133 | ||||||||
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| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087542133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322444700 | ||||||||
| FaxNumber: | 7322448482 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 N. CLAYTON STREET | ||||||||
| Address2: | ST. FRANCES HOSPITAL MEDICAL BUILDING | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322444700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2011 | ||||||||
| LastUpdateDate: | 02/14/2011 | ||||||||
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| AuthorizedOfficialLastName: | GEFFNER | ||||||||
| AuthorizedOfficialFirstName: | RAMI | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 7322444700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207NS0135X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology | 207ND0900X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology |
No ID Information.