ADVANCED DERMATOLOGY LASER AND MOHS SURGERY CENTER NPI 1164416301

NPI Information

  • NPI: 1164416301
  • Provider Name: ADVANCED DERMATOLOGY LASER AND MOHS SURGERY CENTER
  • Classification: Dermatology - 207ND0101X
  • Specialization: MOHS-Micrographic Surgery
  • Entity Type: Organization
  • CLIA Number: 31D0107596
  • Address: 240 E GROVE ST
    WESTFIELD, NJ
    ZIP 07090
  • Phone: (908) 232-6446

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NPI Details

ADVANCED DERMATOLOGY LASER AND MOHS SURGERY CENTER is a mohs-micrographic surgery dermatology in Westfield, NJ. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. ADVANCED DERMATOLOGY LASER AND MOHS SURGERY CENTER NPI is 1164416301. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

240 E GROVE ST
WESTFIELD, NJ
ZIP 07090-687
Phone: (908) 232-6446
Fax: (908) 232-6447

The provider's authorized official is Jerold Bruce Graff .
The authorized official title is President and has the following contact phone number (908) 232-6446.

The CLIA number assigned to this NPI record is 31D0107596 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/2/2005 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic SurgeryYes
2207NS0135XDermatologyProcedural DermatologyX
3207N00000XDermatologyX

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This page was last updated on: 3/30/2025

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