Organization
MEDICAL AND COSMETIC DERMATOLOGY OF CAPE COD
Active
Other names
Medical and Cosmetic Dermatology of Cape Cod PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN ISRAEL MORENO DO (PHYSICIAN PRESIDENT)
(508) 771-7790
Entity
Organization
Contact information
Practice address
700 ATTUCKS LN, HYANNIS, MA 02601-1809
(508) 771-7790
(508) 771-7793
Mailing address
PO BOX 845963, BOSTON, MA 02284
(508) 771-7790
(508) 771-7793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9735810
—
MA
01
—
M18885
BLUE SHIELD
MA
Enumeration date
07/23/2006
Last updated
10/23/2008
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