Provider Demographics
NPI:1568877447
Name:DERMCARE EXPERTS LLC
Entity Type:Organization
Organization Name:DERMCARE EXPERTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUOHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-253-7165
Mailing Address - Street 1:1250 HANCOCK ST
Mailing Address - Street 2:SUITE 505S
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4339
Mailing Address - Country:US
Mailing Address - Phone:781-253-7165
Mailing Address - Fax:781-253-7166
Practice Address - Street 1:1250 HANCOCK ST
Practice Address - Street 2:SUITE 505S
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4339
Practice Address - Country:US
Practice Address - Phone:781-253-7165
Practice Address - Fax:781-253-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247440207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS100162187Medicare PIN