Provider Demographics
NPI:1285857110
Name:HAMETZ & PICASCIA DERMATOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:HAMETZ & PICASCIA DERMATOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-462-9800
Mailing Address - Street 1:77 SCHANCK RD # 55
Mailing Address - Street 2:SUITE B-3
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2964
Mailing Address - Country:US
Mailing Address - Phone:732-462-9800
Mailing Address - Fax:732-308-1647
Practice Address - Street 1:77 SCHANCK RD # 55
Practice Address - Street 2:SUITE B-3
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2964
Practice Address - Country:US
Practice Address - Phone:732-462-9800
Practice Address - Fax:732-308-1647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA34616174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1306865613OtherDR PICASCIA NPI NUMBER
NJ1992720999OtherDR HAMETZ NPI NUMBER
NJ563040Medicare ID - Type UnspecifiedDR PICASCIA MEDICARE #
NJ654694Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJ1306865613OtherDR PICASCIA NPI NUMBER
NJC59716Medicare UPIN
NJE53152Medicare UPIN