Provider Demographics
NPI:1730102666
Name:WARREN DERMATOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:WARREN DERMATOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYLAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-756-7999
Mailing Address - Street 1:122 MOUNT BETHEL RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5127
Mailing Address - Country:US
Mailing Address - Phone:908-756-7999
Mailing Address - Fax:908-756-8017
Practice Address - Street 1:122 MOUNT BETHEL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5127
Practice Address - Country:US
Practice Address - Phone:908-756-7999
Practice Address - Fax:908-756-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty