| NPI | 1669844163 |
|---|---|
| Doing Business As | NORTHEAST DERMATOLOGY ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MATHISON-REYNOLDS Credentialing Manager 937-241-5930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2024-10-23 |