Provider Demographics
NPI:1780631648
Name:MACAIONE & PAPA DERMATOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:MACAIONE & PAPA DERMATOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-627-1900
Mailing Address - Street 1:707 WHITE HORSE RD
Mailing Address - Street 2:SUITE C103
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2461
Mailing Address - Country:US
Mailing Address - Phone:856-627-1900
Mailing Address - Fax:856-627-6907
Practice Address - Street 1:707 WHITE HORSE RD
Practice Address - Street 2:SUITE C103
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2461
Practice Address - Country:US
Practice Address - Phone:856-627-1900
Practice Address - Fax:856-627-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB70671174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ093932Medicare ID - Type Unspecified
NJH04575Medicare UPIN