Organization
DERMATOLOGY AND SKIN SURGERY CENTER OF CAPE COD P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY P TIERNEY MD (AUTHORIZED REP/OWNER)
(508) 957-1650
Entity
Organization
Contact information
Practice address
120 YARMOUTH RD, HYANNIS, MA 02601-3040
(508) 957-1650
(508) 957-1655
Mailing address
120 YARMOUTH RD, HYANNIS, MA 02601-3040
(508) 957-1650
(508) 957-1655
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110108806A
—
MA
Enumeration date
12/10/2015
Last updated
05/14/2019
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