Organization
NEW ENGLAND DERMATOLOGY, P.C.
Active
Other names
NEW ENGLAND DERMATOLOGY & LASER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LOOSEMORE MD (MANAGING PARTNER)
(413) 733-9600
Entity
Organization
Contact information
Practice address
3455 MAIN ST, SUITE 5, SPRINGFIELD, MA 01107-1147
(413) 733-9600
(413) 732-6534
Mailing address
3455 MAIN ST, SUITE 5, SPRINGFIELD, MA 01107-1147
(413) 733-9600
(413) 732-6534
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607424
TUFTS HEALTH PLANS
—
01
—
CC5429
RAILROAD MEDICARE
—
01
—
CE3094
RAILROAD MEDICARE
—
01
—
NEM11488
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/07/2005
Last updated
09/04/2024
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