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Organization

PARK DERMATOLOGY ASSOC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAY M RITT MD (PHYSICIAN)
(508) 894-5100
Entity
Organization

Contact information

Practice address
ONE PEARL ST, STE 2300, BROCKTON, MA 02301
(508) 894-5100
(508) 894-5111
Mailing address
ONE PEARL ST, STE 2300, BROCKTON, MA 02301
(508) 894-5100
(508) 894-5111

Taxonomy

Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9717404
MA
Enumeration date
07/20/2006
Last updated
02/12/2008
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