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Organization
DEROSA FACIAL PLASTIC SURGERY PC
Active
Organization
DEROSA FACIAL PLASTIC SURGERY PC
Active
Other names
DeRosa Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIMIE DEROSA MD (PRESIDENT)
(617) 262-8000
Entity
Organization
Contact information
Practice address
91 NEWBURY ST, SUITE 300, BOSTON, MA 02116-3084
(617) 262-8000
(617) 262-8002
Mailing address
91 NEWBURY ST, SUITE 300, BOSTON, MA 02116-3084
(617) 262-8000
(617) 262-8002
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
237016
MA
Other
Enumeration date
05/01/2013
Last updated
10/15/2014
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