# PARK DERMATOLOGY ASSOC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598785016
- **Authorized official:** DR. JAY M RITT MD (PHYSICIAN)
- **Authorized official phone:** (508) 894-5100

## Contact information

- **Practice address:** ONE PEARL ST, STE 2300, BROCKTON, MA 02301
- **Practice address phone:** (508) 894-5100
- **Practice address fax:** (508) 894-5111
- **Mailing address:** ONE PEARL ST, STE 2300, BROCKTON, MA 02301
- **Mailing address phone:** (508) 894-5100
- **Mailing address fax:** (508) 894-5111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | NULL | Yes |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 02/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 9717404 | — | MA |