Provider Demographics
NPI:1871638940
Name:ADVANCED DERMATOLOGY ASSOCIATES, P.A.
Entity type:Organization
Organization Name:ADVANCED DERMATOLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CITRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-535-3200
Mailing Address - Street 1:315 E NORTHFIELD RD
Mailing Address - Street 2:2A
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4896
Mailing Address - Country:US
Mailing Address - Phone:973-535-3200
Mailing Address - Fax:973-535-1450
Practice Address - Street 1:101 OLD SHORT HILLS RD STE 205
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1093
Practice Address - Country:US
Practice Address - Phone:973-243-2300
Practice Address - Fax:973-243-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty