Provider Demographics
NPI:1003532979
Name:ACCESS DERMATOLOGY LLC
Entity Type:Organization
Organization Name:ACCESS DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-912-3376
Mailing Address - Street 1:385 ROUTE 18 STE E
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5703
Mailing Address - Country:US
Mailing Address - Phone:855-912-3376
Mailing Address - Fax:855-621-3296
Practice Address - Street 1:385 ROUTE 18 STE E
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5703
Practice Address - Country:US
Practice Address - Phone:855-912-3376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty