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CENTRAL MASS DERMATOLOGY NPI 1730339284


NPI Information

NPI: 1730339284
Provider Name: CENTRAL MASS DERMATOLOGY
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
222 MAIN STREET
SOUTHBRIDGE, MA
ZIP 01550
Phone: (508) 765-7711
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CENTRAL MASS DERMATOLOGY is a procedural dermatology dermatology in Southbridge, MA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). CENTRAL MASS DERMATOLOGY NPI is 1730339284. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

222 MAIN STREET
SOUTHBRIDGE, MA
ZIP 01550-593
Phone: (508) 765-7711
Fax: (508) 765-7713

The provider's authorized official is Kathryn Edith Swanson .
The authorized official title is Owner/president and has the following contact phone number (508) 765-7711.

The enumeration date for this NPI number is 9/21/2008 and was last updated on 1/3/2019.


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
1363LF0000XNurse PractitionerFamily178544MASSACHUSETTSNo
2207NS0135XDermatologyProcedural DermatologyYes

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
1110081099AMEDICAIDMASSACHUSETTS

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: 11/14/2023

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