Basic Information
| Provider Information | |||||||||
| NPI: | 1871893529 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACCURATE DERMATOLOGY PA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 2104 | ||||||||
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| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087542104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327316118 | ||||||||
| FaxNumber: | 7322448482 | ||||||||
| Practice Location | |||||||||
| Address1: | 2805 FRINGE LANE | ||||||||
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| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327316118 | ||||||||
| FaxNumber: | 7322448482 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2010 | ||||||||
| LastUpdateDate: | 10/28/2010 | ||||||||
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| AuthorizedOfficialLastName: | MOSCATO | ||||||||
| AuthorizedOfficialFirstName: | RACHELE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7327316118 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ND0101X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207ND0900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | 207NS0135X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology | 2085R0001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 207N00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.