Provider Demographics
NPI:1851544423
Name:DERMATOLOGY CONSULTANTS OF MILLBURN
Entity Type:Organization
Organization Name:DERMATOLOGY CONSULTANTS OF MILLBURN
Other - Org Name:DERMATOLOGY CONSULTANTS OF SHORT HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-232-6245
Mailing Address - Street 1:636 MORRIS TPKE
Mailing Address - Street 2:SUITE 2H
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2622
Mailing Address - Country:US
Mailing Address - Phone:973-232-6245
Mailing Address - Fax:973-232-6247
Practice Address - Street 1:636 MORRIS TPKE
Practice Address - Street 2:SUITE 2H
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2622
Practice Address - Country:US
Practice Address - Phone:973-232-6245
Practice Address - Fax:973-232-6247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08341900207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty