Provider Demographics
NPI:1437321700
Name:DERMATOLOGY ASSOCIATES,PA
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES,PA
Other - Org Name:DERMATOLOGY ASSOC OF ENGLEWOOD PA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:FEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-568-6977
Mailing Address - Street 1:363 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4104
Mailing Address - Country:US
Mailing Address - Phone:201-568-6977
Mailing Address - Fax:201-568-7567
Practice Address - Street 1:363 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4104
Practice Address - Country:US
Practice Address - Phone:201-568-6977
Practice Address - Fax:201-568-7567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3040607Medicaid
NJ20057OtherRAILROAD MEDICARE TRAVELE
NJ428331Medicare PIN
NJ3040607Medicaid
NJ20057OtherRAILROAD MEDICARE TRAVELE