Provider Demographics
NPI:1407194319
Name:APDERM NASHOBA, PC.
Entity Type:Organization
Organization Name:APDERM NASHOBA, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-371-7010
Mailing Address - Street 1:526 MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-371-7010
Mailing Address - Fax:978-371-0522
Practice Address - Street 1:190 GROTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1124
Practice Address - Country:US
Practice Address - Phone:978-772-2424
Practice Address - Fax:978-369-6260
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT & PEDIATRIC DERMATOLOGY, PC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-28
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty