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WORCESTER DERMATOLOGY ASSOCIATES P.C. NPI 1144211681


NPI Information

NPI: 1144211681
Provider Name: WORCESTER DERMATOLOGY ASSOCIATES, P.C.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
100 CENTRAL ST
WORCESTER, MA
ZIP 01608
Phone: (508) 754-3823
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WORCESTER DERMATOLOGY ASSOCIATES, P.C. is a specialist in Worcester, MA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. WORCESTER DERMATOLOGY ASSOCIATES, P.C. NPI is 1144211681. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 CENTRAL ST
WORCESTER, MA
ZIP 01608-209
Phone: (508) 754-3823
Fax: (508) 753-0151

The provider's authorized official is Lori Kixmiller .
The authorized official title is Office Manager and has the following contact phone number (508) 754-3823.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 2/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist75849MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19700340MEDICAIDMASSACHUSETTS
2M17485OTHERMASSACHUSETTSBLUE SHIELD GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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