Provider Demographics
NPI:1932347507
Name:CENTRAL JERSEY SKIN CARE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CENTRAL JERSEY SKIN CARE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:G
Authorized Official - Last Name:WININGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-499-0440
Mailing Address - Street 1:1125 ST. GEORGES AVE.
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065
Mailing Address - Country:US
Mailing Address - Phone:732-499-0440
Mailing Address - Fax:732-499-0225
Practice Address - Street 1:1125 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2631
Practice Address - Country:US
Practice Address - Phone:732-499-0440
Practice Address - Fax:732-499-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA035301207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ527888Medicare PIN