Healthcare Provider Details

I. General information

NPI: 1790587814
Provider Name (Legal Business Name): CLEARVIEW DERMATOLOGY GREATER BOSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BEDFORD ST
LEXINGTON MA
02420-1535
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: 978-962-3281
  • Fax: 978-534-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRI STARR
Title or Position: PRACTICE MANAGER
Credential:
Phone: 978-962-3281