Provider Demographics
NPI:1376858548
Name:ACADEMIC DERMATOLOGY INC
Entity Type:Organization
Organization Name:ACADEMIC DERMATOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:URMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-210-8471
Mailing Address - Street 1:75 VERONICA AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5002
Mailing Address - Country:US
Mailing Address - Phone:732-246-9900
Mailing Address - Fax:732-246-9902
Practice Address - Street 1:75 VERONICA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5002
Practice Address - Country:US
Practice Address - Phone:732-246-9900
Practice Address - Fax:732-246-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty