Provider Demographics
NPI:1720236110
Name:ENHANCE DERMATOLOGY, PC
Entity type:Organization
Organization Name:ENHANCE DERMATOLOGY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-307-0075
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-0002
Mailing Address - Country:US
Mailing Address - Phone:201-307-0075
Mailing Address - Fax:201-307-5072
Practice Address - Street 1:221 W GRAND AVE STE 102B
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1729
Practice Address - Country:US
Practice Address - Phone:201-307-0075
Practice Address - Fax:201-307-5072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty