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NPI Code Detail

MEDICARE: VLADIMIR RATUSHNY M.D., PH.D.

MEDICARE: VLADIMIR RATUSHNY M.D., PH.D.
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
1207N00000XDermatology Physician269395MA

General Provider Information

NPI Number : 1871932590
Entity Type Code : Individual
Provider Name (Legal Business Name) : VLADIMIR RATUSHNY M.D., PH.D.
Provider Business Mailing Address
First Line : 900 CUMMINGS CTR STE 311T
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6260
Country : US
Telephone Number : 978-225-3376
Fax Number :
Provider Business Practice Location Address
First Line : 900 CUMMINGS CTR STE 311T
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6260
Country : US
Telephone Number : 978-225-3376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2013
Last Update Date : 09/27/2023

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