1649500737 NPI number — AURORA MASSACHUSETTS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649500737 NPI number — AURORA MASSACHUSETTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AURORA MASSACHUSETTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DERMDX, A DIVISION OF SEACOAST PATHOLOGY, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649500737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 CENTER PLZ
Provider Second Line Business Mailing Address:
SUITE 270
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02108-1887
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-628-3376
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CENTER PLZ
Provider Second Line Business Practice Location Address:
SUITE 270
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02108-1887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-628-3376
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CHANDLER
Authorized Official First Name:
ELLEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
603-778-8522

Provider Taxonomy Codes

  • Taxonomy code: 207ZD0900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com