Organization
ORLEANS DERMATOLOGY & LASER THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM KRAVITZ DNP, FNP-BC (OFFICIAL / OWNER)
(508) 255-4050
Entity
Organization
Contact information
Practice address
3 NAMSKAKET ROAD, ORLEANS, MA 02653
(508) 255-4050
(888) 448-6765
Mailing address
3 NAMSKAKET ROAD, ORLEANS, MA 02653
(508) 255-4050
(888) 448-6765
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
RN/NP195664
MA
363LF0000X
Family Nurse Practitioner
RN/NP195664
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1706503
CIGNA
—
Enumeration date
05/07/2013
Last updated
01/15/2014
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