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General NPI Number Information
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NPI Number | 1518204353
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Entity Type | Organization
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Legal Business Name | NEWTON WATERTOWN DERMATOLOGY ASSOCIATES
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 280 WASHINGTON ST SUITE #212
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City | BRIGHTON
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State | MA
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Zip | 02135-3511
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Country | US
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Telephone | 617-783-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 280 WASHINGTON ST SUITE #212
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City | BRIGHTON
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State | MA
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Zip | 02135-3511
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Country | US
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Telephone | 617-783-7100
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. MARK STEWART AMSTER
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Credential |
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Telephone | 617-783-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 70448
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License Number State | MA
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