CRANBERRY SQUARE DERMATOLOGY PC NPI 1982829495

NPI Information

  • NPI: 1982829495
  • Provider Name: CRANBERRY SQUARE DERMATOLOGY PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 434 ROUTE 134
    SUITE 1A
    SOUTH DENNIS, MA
    ZIP 02660
  • Phone: (508) 394-5556

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NPI Details

CRANBERRY SQUARE DERMATOLOGY PC is a specialist in South Dennis, 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. CRANBERRY SQUARE DERMATOLOGY PC NPI is 1982829495. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

434 ROUTE 134
SUITE 1A
SOUTH DENNIS, MA
ZIP 02660-433
Phone: (508) 394-5556
Fax: (508) 394-2735

The provider's authorized official is Amy Beth Koff .
The authorized official title is Owner and has the following contact phone number (508) 394-5556.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 8/28/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist80792MASSACHUSETTSYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F34693MEDICARE UPINMASSACHUSETTS
20000M16787OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
3M21255MEDICARE 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: 11/21/2025

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