Organization
NORTHEAST DERMATOLOGY ASSOCIATES
Active
Parent organization
NORTHEAST DERMATOLOGY ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST DERMATOLOGY ASSOCIATES
Authorized official
DR. JEREMY P FINKLE M.D. (PRESIDENT, NORTHEAST DERMATOLOGY AS)
(978) 691-5690
Entity
Organization
Contact information
Practice address
1 WALLACE BASHAW WAY, SUITE 1002, NEWBURYPORT, MA 01950-3875
(978) 691-5690
(978) 691-5693
Mailing address
401 ANDOVER ST, SUITE 101, NORTH ANDOVER, MA 01845-5076
(978) 691-5690
(978) 691-5693
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M15432
MEDICARE PTAN
MA
Enumeration date
08/24/2011
Last updated
08/24/2011
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