MEDICARE: DR. ABIGAIL HART WALDMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	265614	MA
2	207N00000X	Dermatology Physician	265614	MA
3	207ND0900X	Dermatopathology Physician	265614	MA

General Provider Information

NPI Number	:	1598054926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABIGAIL HART WALDMAN MD

Provider Business Mailing Address
First Line	:	1153 CENTRE ST
Second Line	:	SUITE 4J
City	:	BOSTON
State	:	MA
Zip	:	02130-3446
Country	:	US
Telephone Number	:	617-983-4626
Fax Number	:	617-983-4504

Provider Business Practice Location Address
First Line	:	1153 CENTRE ST
Second Line	:	SUITE 4J
City	:	BOSTON
State	:	MA
Zip	:	02130-3446
Country	:	US
Telephone Number	:	617-983-4626
Fax Number	:	617-983-4504

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	03/13/2026

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