LAKEWOOD DERMATOLOGY (NPI# 1275933780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275933780 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD DERMATOLOGY |
| Practice Address |
14701 Detroit Ave Suite 208 Lakewood OH 44107-4115 |
| Practice Telephone | 2164580322 |
| Practice Fax Number | 2164580325 |
| Mailing Telephone | 2164580322 |
| Mailing Fax Number | 2164580325 |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2014-09-03 |
| Authorized Official Name | DR. STEPHANIE D NEIDER (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 2164580322 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 35081781 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0065021 | 05 |
| Street Address |
14701 DETROIT AVE SUITE 208 |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-4115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699778142 | Richard Allen Statesir | Ophthalmology | 14701 Detroit Ave, Ste 280, Lakewood, OH 44107-4109 | 2005-05-28 |
| 1083277115 | Daniel Vilamaa | Case Manager/Care Coordinator | 14701 Detroit Ave, Lakewood, OH 44107-4115 | 2019-04-15 |
| 1063970713 | Jacob W Loughner | Case Manager/Care Coordinator | 14701 Detroit Ave, Lakewood, OH 44107-4115 | 2019-03-12 |
| 1629585252 | Michael Patrick Wallett | Hearing Instrument Specialist | 14701 Detroit Ave, Lakewood, OH 44107-4115 | 2018-01-04 |
| 1972019644 | Joseph M Guzzi | Hearing Instrument Specialist | 14701 Detroit Ave, Lakewood, OH 44107-4115 | 2017-12-18 |
| 1962877340 | Sara Scarborough | Speech-Language Pathologist | 14701 Detroit Ave, Lakewood, OH 44107-4115 | 2015-12-10 |
| 1477958775 | Deniz F. Koprulu | Nurse Practitioner | 14701 Detroit Ave, Suite 620, Lakewood, OH 44107-4115 | 2014-10-29 |
| 1396149662 | Michelle Scianna | Nurse Practitioner | 14701 Detroit Ave, Suite 522, Lakewood, OH 44107-4115 | 2014-10-15 |
| 1558786871 | Sara Walter Floreth | Counselor | 14701 Detroit Ave, Lakewood, OH 44107-4115 | 2014-02-24 |
| 1144561002 | Brian K. Smith, D.d.s., M.d., Inc. | Dentist | 14701 Detroit Ave, Suite 333, Lakewood, OH 44107-4109 | 2013-03-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
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| 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 |
|---|---|---|---|---|
| 1396864500 | Alpine Dermatology Associates Pllc | Dermatology | 1785 Kipling St, Lakewood, CO 80215-2843 | 2007-03-28 |
| 1295885630 | Fredric Robert Rosenberg | Dermatology | 3650 E. South Street, #306, Lakewood, CA 90712 | 2007-01-10 |
| 1801971098 | Darnell L Martin-wimmer | Dermatology | 1785 Kipling, Lakewood, CO 80215 | 2006-10-26 |
| 1467566208 | Emanuel G Kuflik | Dermatology | 150 E Kennedy Blvd, Lakewood, NJ 08701-1345 | 2006-08-18 |
| 1023044724 | Advanced Dermatology & Skin Surgery, PC | Dermatology | 886 River Ave, Lakewood, NJ 08701-5220 | 2006-06-24 |
| 1497703185 | Kira Rand Giovanielli | Dermatology | 3455 S Yarrow St, Lakewood, CO 80227-5031 | 2006-05-04 |
| 1992762017 | Mordechai M Tarlow | Dermatology | 456 Chestnut St, Suite 201, Lakewood, NJ 08701-6124 | 2006-05-01 |
| 1760749683 | Lisa Ann Blackwood | Dermatology | 3455 S Yarrow St, Lakewood, CO 80227 | 2012-04-17 |
| 1093848509 | Prohealth Partners, A Medical Group | Dermatology | 5750 Downey Ave, Suite 100, Lakewood, CA 90712-1405 | 2007-03-13 |
| 1154407856 | Advanced Dermatology Surgical and Medical Group Inc. | Dermatology | 3650 E South St, #306, Lakewood, CA 90712 | 2006-10-27 |
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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.