Healthcare Provider Details

I. General information

NPI: 1558477869
Provider Name (Legal Business Name): NEWTON WATERTOWN DERMATOLOGY ASSOC. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 WASHINGTON ST STE 212
BRIGHTON MA
02135-3511
US

IV. Provider business mailing address

PO BOX 590129
NEWTON CENTER MA
02459-0002
US

V. Phone/Fax

Practice location:
  • Phone: 617-783-7100
  • Fax: 617-783-7104
Mailing address:
  • Phone: 617-783-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number70448
License Number StateMA

VIII. Authorized Official

Name: DR. MARK STEWART AMSTER
Title or Position: CEO-PRESIDENT
Credential: MD
Phone: 617-783-7100