Dermatology & Laser Surgery Ctr

Public-record details

Address

2125 Center Ave, Suite 200, Fort Lee, NJ 07024

Phone

(201) 461-5655

Listed under

Practices and organizations, Cosmetic and laser (by name)

NPI

1780937045

NPI status

Active in the NPPES registry

Provider type

Organization (practice, clinic or company)

Registered specialty (self-reported taxonomy)

Dermatology (207N00000X)

License number on NPI record

65361 (NJ)

Authorized official

Olga Goulko, MD, Medical Doctor

NPI first issued

Oct 23, 2012

Years since NPI first issued

14 years (since 2012)

License state on NPI record

NJ

NPI record last updated

Oct 17, 2013

NPI 1780937045 is active in the federal NPPES registry (CMS) with Dermatology as its self-reported primary taxonomy; license 65361 (NJ) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Dermatologist Index does not vet, employ, recommend or guarantee dermatology practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Dermatologist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. To check board certification, use the American Board of Dermatology's verification tool (or the American Osteopathic Board of Dermatology for DOs), and confirm the medical license with the state board.

View NPI 1780937045 in the official registry ↗