Provider Demographics
NPI:1851860605
Name:NESC - WIN-LAH, LLC
Entity Type:Organization
Organization Name:NESC - WIN-LAH, LLC
Other - Org Name:DERMCARE PHYSICIANS & SURGEONS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-244-0060
Mailing Address - Street 1:27 VILLAGE SQUARE
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824
Mailing Address - Country:US
Mailing Address - Phone:978-244-0060
Mailing Address - Fax:978-244-2522
Practice Address - Street 1:27 VILLAGE SQUARE
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824
Practice Address - Country:US
Practice Address - Phone:978-244-0060
Practice Address - Fax:978-244-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty