Provider Type Icon

CLIFFSIDE MEDICAL LLC NPI 1104908813


NPI Information

NPI: 1104908813
Provider Name: CLIFFSIDE MEDICAL LLC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 31D0677093

Address:
663 PALISADE AVE
CLIFFSIDE PARK, NJ
ZIP 07010
Phone: (201) 945-6500
Get Directions

CLIFFSIDE MEDICAL LLC is a dermatology in Cliffside Park, NJ. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. CLIFFSIDE MEDICAL LLC NPI is 1104908813. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

663 PALISADE AVE
CLIFFSIDE PARK, NJ
ZIP 07010-012
Phone: (201) 945-6500
Fax: (201) 945-1157

The provider's authorized official is Benjamin S Chouake .
The authorized official title is President and has the following contact phone number (201) 945-6500.

The CLIA number assigned to this NPI record is 31D0677093 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 10/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207P00000XEmergency MedicineNo
3207Q00000XFamily MedicineNo
4208100000XPhysical Medicine & RehabilitationNo
52085R0202XRadiologyDiagnostic RadiologyNo
6208D00000XGeneral PracticeNo
7207N00000XDermatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10820903MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.