Provider Demographics
NPI:1447959713
Name:PARAGON SKIN
Entity type:Organization
Organization Name:PARAGON SKIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ZACHARY
Authorized Official - Last Name:HANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-922-0123
Mailing Address - Street 1:120 YORK ST APT 306
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3752
Mailing Address - Country:US
Mailing Address - Phone:510-922-0123
Mailing Address - Fax:
Practice Address - Street 1:214 COMMONS WAY BLDG B
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6427
Practice Address - Country:US
Practice Address - Phone:732-234-7546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty