Provider Demographics
NPI:1487636924
Name:DERMATOLOGY ASSOCIATES OF WORCESTER COUNTY, P.C.
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF WORCESTER COUNTY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:CAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-534-0582
Mailing Address - Street 1:100 HOSPITAL RD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2253
Mailing Address - Country:US
Mailing Address - Phone:978-534-0582
Mailing Address - Fax:978-534-6519
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-534-0582
Practice Address - Fax:978-534-6519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty