| NPI | 1164867479 |
|---|---|
| Doing Business As | DEROSA CLINIC |
| Entity Type | Organization |
| Authorized Contact | JAIMIE DEROSA President 617-262-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: MA 237016) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2014-10-15 |