| Modern Dermatology And Cosmetic Center Llc | |
|
2510 Belmar Blvd Wall NJ 07719-3948 | |
| (908) 391-1694 | |
| Not Available |
| Full Name | Modern Dermatology And Cosmetic Center Llc |
|---|---|
| Speciality | Dermatology |
| Location | 2510 Belmar Blvd, Wall, New Jersey |
| Authorized Official Name and Position | Iris Hatziminas (OWNER) |
| Authorized Official Contact | 9083911694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dermatology And Cosmetic Center Llc 2510 Belmar Blvd Wall NJ 07719-3948 Ph: () - | Modern Dermatology And Cosmetic Center Llc 2510 Belmar Blvd Wall NJ 07719-3948 Ph: (908) 391-1694 |
| NPI Number | 1376230581 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/18/2023 |
| Medicare PECOS PAC ID | 9133580038 |
|---|---|
| Medicare Enrollment ID | O20230725001302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376230581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
Maria G. Pyontek, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1725 Highway 35, Suite B, Wall, NJ 07719 Phone: 732-681-1063 Fax: 732-681-2922 |