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COSULICH DERMATOLOGY LLC
NPI 1427333632
Dermatology in Wall Township, NJ

Active since October 19, 2011CLIA 31D0880615 · Certificate of Compliance
3350 HIGHWAY 138, BUILDING 2 SUITE 122, WALL TOWNSHIP, NJ 07719(732) 280-1200(732) 280-1207 Get Directions Write a Review

NPPES record last updated: June 7, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Cosulich Dermatology Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COSULICH DERMATOLOGY LLC (NPI 1427333632) is a healthcare organization registered as a dermatology in Wall Township, New Jersey and active in the NPI registry since October 2011. The organization holds a CLIA Certificate of Compliance certificate valid through September 28, 2026 and lists Michael Cosulich, Owner, as its authorized official.

NPPES Registry Identity

NPI1427333632
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCOSULICH DERMATOLOGY LLC
Location Address3350 HIGHWAY 138, BUILDING 2 SUITE 122Wall Township, NJ 07719-9693
Mailing Address3350 Highway 138, Building 2 Suite 122Wall Township, NJ 07719-9693 · (732) 280-1200 · Fax (732) 280-1207
Phone(732) 280-1200
Fax(732) 280-1207
Organization SubpartNo
Authorized OfficialMichael CosulichOwner · (732) 280-1200
Enumeration DateOctober 19, 2011
Last NPPES UpdateJune 7, 2021
NPPES CertifiedJune 7, 2021
✔ NPI 1427333632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NJ · 25MA04679500
Definition
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License 25MA04679500 (NJ)
3350 HIGHWAY 138, Wall Township, NJ 07719
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 31D0880615

Cosulich Dermatology · Wall, NJ
Active · expires Sep 28, 2026
CLIA Number31D0880615
Laboratory TypePhysician Office
Certificate Effective DateSeptember 29, 2024
Certificate Expiration DateSeptember 28, 2026
Laboratory DirectorMichael T. Cosulich
Laboratory Phone(732) 280-1200
Laboratory LocationCosulich Dermatology3350 Hwy 138 West Bld 2, Ste 122, Wall, NJ 07719
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RONALD BARABAS M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
3350 HIGHWAY 138, SUITE 117
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 556-0200
DEREK ANDREW VAN BENTHUYSEN D.C.
Chiropractor
3350 HIGHWAY 138, STE 227
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-1800
MARY FRANCES BEIRNE, M.D., ED.D., P.C.
Clinic/Center (Mental Health (Including Community Mental Health Center))
3350 HIGHWAY 138, SUITE 118
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-2366
MTM PEDIATRICS, LLC
Pediatrics
3350 HIGHWAY 138, BUILDING 2, SUITE 126
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-6455
LAWRENCE G VAN HORN MD PA
Specialist
3350 HIGHWAY 138, BUILDING 1 SUITE 115
WALL TOWNSHIP, NJ 07719
Monmouth County (732) 280-8088
SHOBHA A CHOTTERA MD
Psychiatry & Neurology (Psychiatry)
3350 HIGHWAY 138, AUTUMN RIDGE OFFICE PARK BLD # 2 SUITE 128
WALL, NJ 07719
Monmouth County (732) 280-8850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cosulich Dermatology LLC's NPI number?

The NPI number for Cosulich Dermatology LLC is 1427333632. It was assigned to this organization in the NPPES registry on October 19, 2011.

Where is Cosulich Dermatology LLC located?

Cosulich Dermatology LLC is located at 3350 Highway 138 Building 2 Suite 122, Wall Township, NJ 07719. The listed phone number is (732) 280-1200.

What is Cosulich Dermatology LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Cosulich Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 31D0880615) is associated with this NPI, valid through September 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cosulich Dermatology LLC was last updated on June 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.