Licking Memorial Professional Corporation
NPI 1295775435 · Dermatology Physician · Newark, OH
Licking Memorial Professional Corporation is a Dermatology Physician organization in Newark, OH (NPI 1295775435).
Provider details
- NPI number
- 1295775435
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robert Montagnese, Executive Ice President(740) 348-4000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Licking Memorial Dermatology
Registry dates
- Enumerated
- 2006-06-07
- Last updated
- 2020-08-22
Frequently asked questions
- What is Licking Memorial Professional Corporation's NPI number?
- Licking Memorial Professional Corporation's National Provider Identifier (NPI) is 1295775435, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Licking Memorial Professional Corporation?
- Licking Memorial Professional Corporation is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Licking Memorial Professional Corporation located?
- Licking Memorial Professional Corporation's practice location on file with NPPES is 36 Mcmillen Dr, Newark, OH 43055-3666.
- What is Licking Memorial Professional Corporation's phone number?
- The practice phone number listed in the NPPES registry for Licking Memorial Professional Corporation is (740) 348-1755.
- Who is the authorized official for Licking Memorial Professional Corporation?
- The authorized official listed on Licking Memorial Professional Corporation's NPPES record is Robert Montagnese, Executive Ice President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Licking Memorial Professional Corporation's NPI active?
- Yes — Licking Memorial Professional Corporation's NPI (1295775435) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.