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BROOKLINE DERMATOLOGY ASSOCIATES PC NPI 1811399025


NPI Information

NPI: 1811399025
Provider Name: BROOKLINE DERMATOLOGY ASSOCIATES, PC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 22D2080801

Address:
235 CYPRESS ST
SUITE 200
BROOKLINE, MA
ZIP 02445
Phone: (617) 277-0800
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BROOKLINE DERMATOLOGY ASSOCIATES, PC is a mohs-micrographic surgery dermatology in Brookline, MA. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. BROOKLINE DERMATOLOGY ASSOCIATES, PC NPI is 1811399025. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

235 CYPRESS ST
SUITE 200
BROOKLINE, MA
ZIP 02445-776
Phone: (617) 277-0800
Fax: (617) 277-0899

The provider's authorized official is Maryjane Mushow .
The authorized official title is Chief Operating Officer and has the following contact phone number (617) 608-1575.

The CLIA number assigned to this NPI record is 22D2080801 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/18/2014 and was last updated on 9/18/2014.


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
1207ND0101XDermatologyMOHS-Micrographic Surgery57991MASSACHUSETTSYes

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
1A21780MEDICARE PINMASSACHUSETTS

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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