Modern Dermatology and Cosmetic Center LLC
NPI 1376230581ActiveOrganization· Dermatology· Wall, NJ
Dermatology in Wall, New Jersey, registered in NPPES in April 2023. The authorized official on file is Iris Hatziminas, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376230581 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 18, 2023 |
| Last updated in NPPES | Apr 18, 2023 |
| Certified by provider | Apr 18, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Clinic/Center | 261Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NJ) |
|---|
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