DR. DOUGLAS JAN PRAVDA (NPI# 1427020718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427020718 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS JAN PRAVDA |
| Credential | D.O. |
| Practice Address |
622 Boulevard Kenilworth NJ 07033-1640 |
| Mailing Address |
287 Watchung Frk Westfield NJ 07090-3816 |
| Practice Telephone | 9082413181 |
| Practice Fax Number | 9082411669 |
| Mailing Telephone | 9082337383 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2010-06-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 25MB03272500 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | UNIVERSAL CREDENTIALING | 10664103 | 01 |
| NJ | OTHER INSURANCE COMPANIES | 127381096 | 01 |
| NH | OXFORD INSURANCE | US-292 | 01 |
| Street Address |
622 BOULEVARD |
| City | KENILWORTH |
| State | NJ |
| Zip Code | 07033-1640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396112231 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 801 Kenilworth Blvd, Kenilworth, NJ 07033 | 2015-08-26 |
| 1235480484 | Yesenia Fermin | Social Worker | 525 Boulevard Suite 2, Suite 2, Kenilworth, NJ 07033 | 2012-09-27 |
| 1255467064 | Afzaal Ahmad Siddiqui | Anesthesiology | Garden State Endoscopy & Surgery Center, 1700 Galloping Hill Road, Kenilworth, NJ 07033 | 2007-02-26 |
| 1497894059 | Paul Morabito | Pharmacist | 21 North 20th Street, Morabitos Pharmacy, Kenilworth, NJ 07033 | 2007-02-06 |
| 1780747394 | Morris Avenue Endoscopy LLC | Clinic/Center | #1700 Galloping Hill Rd, Kenilworth, NJ 07033 | 2006-12-18 |
| 1477641363 | Lois G Fiore | Optometrist | 505 Boulevard, Kenilworth, NJ 07033 | 2006-10-10 |
| 1518058189 | Glenn W Koechling Dds | Dentist | 17 North 18th Street, Kenilworth, NJ 07033 | 2006-09-27 |
| 1992344766 | Zisi Monheit | Pharmacist | 312 Glenwood Avenue, Bloomfield, NJ 07033 | 2019-12-27 |
| 1730491812 | Ahmad Kazemi Md Pa | General Practice | 562 Boulevard, Kenilworth, NJ 07033 | 2010-07-06 |
| 1942330006 | Dominick Morabito | Pharmacist | 21 N 20th St, Kenilworth, NJ 07033 | 2007-03-07 |
| Find all providers in zip 07033 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649716 | Danowski Dermatology | Dermatology | 525 Route 73 N Ste 305a, Marlton, NJ 08053-3422 | 2020-11-03 |
| 1508477399 | Consonant Healing Medical Associates of Nj LLC | Dermatology | 100 Challenger Rd # 205, Ridgefield Park, NJ 07660-2108 | 2020-08-13 |
| 1659900884 | Dermatology and Skin Care Center | Dermatology | 2301 E Evesham Rd Ste 102-103, Voorhees, NJ 08043-4501 | 2020-04-08 |
| 1467091983 | Aura Dermatology At Somerset LLC | Dermatology | 75 Veronica Ave Ste 205, Somerset, NJ 08873-5002 | 2020-01-01 |
| 1578025920 | Aura Dermatology At Robbinsville LLC | Dermatology | 17 Main St Ste 304, Robbinsville, NJ 08691-1436 | 2019-04-04 |
| 1144786740 | Swetha Kandula Md LLC | Dermatology | 3695 Hill Rd Ste 2b, Parsippany, NJ 07054-1047 | 2019-02-19 |
| 1477031318 | Wellness Dermatology LLC | Dermatology | 638 Lawrenceville Rd, Lawrenceville, NJ 08648-4208 | 2018-08-02 |
| 1871000323 | Julianna Nicole Jarvis | Dermatology | 100 Brick Rd Ste 306, Marlton, NJ 08053-2146 | 2018-01-05 |
| 1487169702 | Nj Certified Dermatology PC | Dermatology | 670 Broadway, Bayonne, NJ 07002-4726 | 2017-12-08 |
| 1407374796 | Geria Dermatology, LLC | Dermatology | 75 Orient Way Ste 204, Rutherford, NJ 07070-2086 | 2017-09-06 |
| Find all providers with the same taxonomy | ||||
| City | KENILWORTH |
| Zip Code | 07033 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.