KEYSTONE DERMATOLOGY & CENTER FOR SKIN SURGERY, LLC (NPI# 1558549733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558549733 |
| Entity Type | Organization |
| Organization Name | KEYSTONE DERMATOLOGY & CENTER FOR SKIN SURGERY, LLC |
| Practice Address |
2525 9th Ave Ste 2 Altoona PA 16602-2014 |
| Mailing Address |
2525 9th Ave Ste 2a Altoona PA 16602-2014 |
| Practice Telephone | 8149437546 |
| Mailing Telephone | 8149437546 |
| Mailing Fax Number | 8149437544 |
| Enumeration Date | 2008-02-10 |
| Last Update Date | 2008-05-29 |
| Authorized Official Name | DR. GREGORY JOHN FULCHIERO JR. (OWNER/OPERATOR/PHYSICIAN) |
| Authorized Official Telephone | 8149437546 |
| Authorized Official Credential | M.D., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD432947 | PA | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
MD432947 | PA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD432947 | PA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | MD432947 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CLIA | 39D1084575 | 01 |
| PA | N/A | N/A | 01 |
| Street Address |
2525 9TH AVE STE 2 |
| City | ALTOONA |
| State | PA |
| Zip Code | 16602-2014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817646 | John Francis Cain | Registered Nurse | 319 Meadowlark Ave, Altoona, PA 16602 | 2020-10-06 |
| 1023650991 | Rahaf Obeid | Pharmacist | 508 E Plank Road, Altoona, PA 16602 | 2019-10-12 |
| 1346713641 | Justin M Delasko | Dietitian, Registered | 905 Logan Blvd, Altoona, PA 16602 | 2019-01-09 |
| 1679932420 | Dottie Jean Morgan | Speech-Language Pathologist | 501 Valley View Blvd., Altoona, PA 16602 | 2016-02-22 |
| 1922409283 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1600 9th Avenue, Altoona, PA 16602 | 2014-09-05 |
| 1972918878 | Grane Hospice Care, Inc. | Hospice Care, Community Based | 115 Union Ave Ste 100, Altoona, PA 16602 | 2014-06-30 |
| 1033524921 | Grane Hospice Care, Inc. | Home Health | 115 Union Ave Ste 300, Altoona, PA 16602 | 2014-06-30 |
| 1306184858 | Lighthouse Medical, LLC | Physical Medicine & Rehabilitation | 301 E. Pleasant Valley Blvd, Altoona, PA 16602 | 2013-01-17 |
| 1497042576 | Michala Seidel | Counselor | 3010 7th Avenue, Alternative Community Resource Program, Altoona, PA 16602 | 2011-07-08 |
| 1205121647 | Rebekah Brown | Preventive Medicine | 301 E Pleasant Valley Blvd., Altoona, PA 16602 | 2011-06-14 |
| Find all providers in zip 16602 | ||||
| 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 |
|---|---|---|---|---|
| 1942414115 | Gregory John Fulchiero Jr. | Dermatology | 2525 9th Ave Ste 2a, Altoona, PA 16602-2014 | 2007-05-09 |
| 1780663104 | Alice Plummer Joyce | Dermatology | 1101 Logan Blvd, Altoona Dermatology Associates, Altoona, PA 16602-4029 | 2006-01-13 |
| 1801871868 | Henry D. Mckinney | Dermatology | 1800 - Grant Ave, Altoona, PA 16602-4508 | 2005-12-13 |
| 1841778685 | Altoona Dermatology Associates LLC | Dermatology | 1101 Logan Blvd, Altoona, PA 16602-4029 | 2018-08-03 |
| 1932235686 | Sheela G. Kerstetter | Dermatology | 1414 9th Ave, Station Medical Center, Altoona, PA 16602-2415 | 2007-02-26 |
| 1962544809 | Blair Medical Associates | Dermatology | 1414 9th Ave, Station Medical Center, Altoona, PA 16602-2415 | 2007-02-13 |
| 1639286768 | Fanny X Louton | Dermatology | 3107 Fairway Dr, Altoona, PA 16602 | 2006-08-24 |
| 1306825658 | John P Joyce | Dermatology | 1101 Logan Blvd, Altoona Dermatology Associates, Altoona, PA 16602-4029 | 2006-01-14 |
| 1881672368 | Jane E Rowe | Dermatology | 1414 9th Ave, Station Medical Center, Altoona, PA 16602-2454 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013748 | Consonant Healing Medical Associates of Pa LLC | Dermatology | 49 Smith Mill Rd, New Freedom, PA 17349-8147 | 2020-08-13 |
| 1790395747 | Dermatology Specialists of Pennsylvania | Dermatology | 1122 Street Rd Ste 204, Southampton, PA 18966-4218 | 2020-08-05 |
| 1275151458 | Sylvan Dermatology LLC | Dermatology | 32 Parking Plz Ste 300, Ardmore, PA 19003-2443 | 2020-07-14 |
| 1841819455 | Rowe Dermatology, Pllc | Dermatology | 519 Owen Rd, Wynnewood, PA 19096-1714 | 2020-04-14 |
| 1750923579 | Alliance Dermatology Physicians, P.C. | Dermatology | 1205 Langhorne Newtown Road Suite 215, Langhorne, PA 19047 | 2019-10-14 |
| 1346882651 | Whalen Dermatology of Pittsburgh PC | Dermatology | 160 Millers Run Rd Ste 500, Bridgeville, PA 15017-1358 | 2019-10-09 |
| 1932740461 | Mark Abdelmalek, Md LLC | Dermatology | 200 N 16th St Ste D, Philadelphia, PA 19102-1225 | 2019-10-07 |
| 1093368185 | Alliance Dermatology Physicians, P.C. | Dermatology | 1205 Langhorne Newtown Rd Ste 215a, Langhorne, PA 19047-1219 | 2019-07-18 |
| 1821573619 | St. Luke's Physician Group, Inc | Dermatology | 1600 St Lukes Blvd Ste 100, Easton, PA 18045-5671 | 2018-09-27 |
| 1588147748 | Pittsburgh Skin PC | Dermatology | 144 Emeryville Dr Ste 230, Cranberry Twp, PA 16066-5015 | 2018-09-12 |
| Find all providers with the same taxonomy | ||||
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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.