| NPI | 1568602969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L SARUK Chief Executive Officer 302-478-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207ND0900X Dermatology Dermatopathology | |
| 207NS0135X Dermatology Procedural Dermatology | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2021-06-04 |