Organization · NPI-2

Bay Dermatology PC

Dermatology · Toms River, NJ

NPI number1679702476
StatusActive
Last updated in NPPESOct 8, 2015

Details

NPI
1679702476
Entity type
Organization (NPI-2)
Legal business name
Bay Dermatology PC
Organization subpart
No
Enumeration date
Jul 14, 2009
Last updated
Oct 8, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology––Yes
363L00000X Nurse Practitioner––

Practice location

780 Route 37 W Ste 235
Toms River, NJ 08755-5065

Phone 732-557-9300 · Fax 732-557-9010

Mailing address

780 Route 37 W Ste 235
Toms River, NJ 08755-5065

Phone 732-557-9300 · Fax 732-557-9010

Authorized official

Sal Thomas Laforgia
Shareholder
7325579300

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