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General NPI Number Information
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NPI Number | 1679765630
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Entity Type | Organization
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Legal Business Name | DINELI, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 04/15/2012
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Provider Practice Location Address
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Address Line | 9 NORTH RD SUITE 202
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City | CHELMSFORD
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State | MA
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Zip | 01824-2755
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Country | US
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Telephone | 978-275-9440
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Fax | 978-275-9470
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Provider Business Mailing Address
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Address Line | 9 NORTH RD SUITE 202
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City | CHELMSFORD
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State | MA
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Zip | 01824-2755
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Country | US
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Telephone | 978-275-9440
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Fax | 978-275-9470
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Authorized Official
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Title or Position | OWNER
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Name | DR. DINA A ELIOPOULOS
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Credential | M.D.
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Telephone | 978-275-9440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 203898
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License Number State | MA
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