| Organization Name: | COSULICH DERMATOLOGY LLC |
| NPI Number: | 1427333632 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM FRANCIS COSULICH (OWNER) |
| Mailing Address: | 3350 Highway 138 Building 2 Suite 122 Wall Township |
| State: | NJ US |
| Postal Code: | 077199693 |
| Phone Number: | 7322801200 |
| Fax Number: | 7322801207 |
| NPI Enumeration Date: | 10/19/2011 |
| NPI Last Update Date: | 10/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207ND0101X |
| License Number: | 25MA04679500 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Dermatology |
| Taxonomy Specialization: | MOHS-Micrographic Surgery |
| Taxonomy Definition: | The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |