| Gregory Blase Persichetti, DO | |
|
100 Kings Way E, Suite A-3, Sewell, NJ 08080-2237 | |
| (856) 589-3331 | |
| (856) 589-3416 |
| Full Name | Gregory Blase Persichetti |
|---|---|
| Gender | Male |
| Speciality | Dermatology - Mohs-micrographic Surgery |
| Location | 100 Kings Way E, Sewell, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518901925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 25MB08242000 (New Jersey) | Primary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 08012552 (Pennsylvania) | Secondary |
| Entity Name | Associates In Medical And Cosmetic Dermatology, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477639425 PECOS PAC ID: 4385624931 Enrollment ID: O20040723000240 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Blase Persichetti, DO 100 Kings Way E, Suite A-3, Sewell, NJ 08080-2237 Ph: (856) 589-3331 | Gregory Blase Persichetti, DO 100 Kings Way E, Suite A-3, Sewell, NJ 08080-2237 Ph: (856) 589-3331 |
Elana Tova Segal, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 100 Kings Way E Ste A3, Washington Pavilions, Sewell, NJ 08080 Phone: 856-589-3331 Fax: 856-589-3416 | |
Kehua Li, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 570 Egg Harbor Rd, Suite C-1, Sewell, NJ 08080 Phone: 856-256-8899 Fax: 856-256-8868 | |
Booth Hammond Durham, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 570 Egg Harbor Rd Ste C1, Sewell, NJ 08080 Phone: 856-256-8899 | |
Rachel Bognet, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 570 Egg Harbor Rd, Suite C-1, Sewell, NJ 08080 Phone: 856-256-8899 Fax: 856-256-8868 | |
Birgit K Toome, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 570 Egg Harbor Rd Ste C1, Sewell, NJ 08080 Phone: 856-256-8899 Fax: 856-256-8868 | |
Jonathan Winter, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 100 Kings Way E, Washington Pavilions Suite A-3, Sewell, NJ 08080 Phone: 856-589-3331 Fax: 856-589-3416 |