Provider Demographics
NPI:1255190864
Name:SKINTEGRATIVE SOLUTIONS LLC
Entity type:Organization
Organization Name:SKINTEGRATIVE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROCCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-251-9419
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-0512
Mailing Address - Country:US
Mailing Address - Phone:908-251-9419
Mailing Address - Fax:
Practice Address - Street 1:108 BILBY RD
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4174
Practice Address - Country:US
Practice Address - Phone:908-251-9419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty