Provider Demographics
NPI:1619141439
Name:ASSOCIATED DERMATOLOGISTS OF MONMOUTH P C
Entity Type:Organization
Organization Name:ASSOCIATED DERMATOLOGISTS OF MONMOUTH P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-219-0700
Mailing Address - Street 1:92 HALF MILE RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5638
Mailing Address - Country:US
Mailing Address - Phone:732-219-0700
Mailing Address - Fax:732-219-9224
Practice Address - Street 1:92 HALF MILE RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5638
Practice Address - Country:US
Practice Address - Phone:732-219-0700
Practice Address - Fax:732-219-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA37523207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty