Healthcare Provider Details

I. General information

NPI: 1710342878
Provider Name (Legal Business Name): LEOMINSTER DERMATOLOGY LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2015
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD STE 2D
LEOMINSTER MA
01453-2253
US

IV. Provider business mailing address

100 HOSPITAL RD STE 2D
LEOMINSTER MA
01453-2253
US

V. Phone/Fax

Practice location:
  • Phone: 978-534-0582
  • Fax: 978-534-6519
Mailing address:
  • Phone: 978-534-0582
  • Fax: 978-534-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number55708
License Number StateMA

VIII. Authorized Official

Name: DR. STEVEN FRANKS
Title or Position: SUPERVISING MD
Credential: M.D.
Phone: 978-534-0582