Provider Demographics
NPI:1710088216
Name:NORTHAMPTON DERMATOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NORTHAMPTON DERMATOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-586-5798
Mailing Address - Street 1:190 NONOTUCK STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062
Mailing Address - Country:US
Mailing Address - Phone:413-586-5798
Mailing Address - Fax:413-585-0587
Practice Address - Street 1:190 NONOTUCK STREET
Practice Address - Street 2:SUITE 107
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062
Practice Address - Country:US
Practice Address - Phone:413-586-5798
Practice Address - Fax:413-585-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty