Provider Demographics
NPI:1043563786
Name:DERMATOLOGY AND SKIN CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:DERMATOLOGY AND SKIN CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-235-8155
Mailing Address - Street 1:10 LAUREL AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-7536
Mailing Address - Country:US
Mailing Address - Phone:781-235-8155
Mailing Address - Fax:
Practice Address - Street 1:10 LAUREL AVE STE 300
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-7536
Practice Address - Country:US
Practice Address - Phone:781-235-8155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty