Healthcare Provider Details

I. General information

NPI: 1740029032
Provider Name (Legal Business Name): VUE DERMATOLOGY & LASER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 NORWOOD PARK S STE 202
NORWOOD MA
02062-4633
US

IV. Provider business mailing address

115 NORWOOD PARK S STE 202
NORWOOD MA
02062-4633
US

V. Phone/Fax

Practice location:
  • Phone: 781-725-0505
  • Fax:
Mailing address:
  • Phone: 781-725-0505
  • Fax: 781-725-0555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. PHILIP ELIADES
Title or Position: OWNER
Credential: MD
Phone: 781-725-0505