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General NPI Number Information
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NPI Number | 1891609277
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Entity Type | Organization
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Legal Business Name | INTEGRATED DERMATOLOGY MASSACHUSETTS, LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 1101 BEACON ST STE 1E
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City | BROOKLINE
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State | MA
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Zip | 02446-5587
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Country | US
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Telephone | 617-731-2390
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Fax | 617-731-1283
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Provider Business Mailing Address
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Address Line | 4700 EXCHANGE CT STE 110
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City | BOCA RATON
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State | FL
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Zip | 33431-4450
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Country | US
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Telephone | 561-948-0291
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Fax | 561-859-0429
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Authorized Official
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Title or Position | CFO
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Name | JENNIFER MORGAN
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Credential |
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Telephone | 561-223-8081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | NULL
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