Provider Demographics
NPI:1437665908
Name:KUCHNIR DERMATOLOGY, PC
Entity Type:Organization
Organization Name:KUCHNIR DERMATOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHNIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-450-6141
Mailing Address - Street 1:340 MAPLE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3200
Mailing Address - Country:US
Mailing Address - Phone:508-450-6141
Mailing Address - Fax:508-485-7769
Practice Address - Street 1:20 HOPE AVE STE 105
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2717
Practice Address - Country:US
Practice Address - Phone:781-891-1540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty