Provider Demographics
NPI:1659583227
Name:BAYONNE DERMATOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:BAYONNE DERMATOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VADIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-339-6681
Mailing Address - Street 1:844 AVE C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:201-339-6681
Mailing Address - Fax:201-626-4041
Practice Address - Street 1:844 AVE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002
Practice Address - Country:US
Practice Address - Phone:201-339-6681
Practice Address - Fax:201-626-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty