Advanced Dermatology of Melrose, PLLC

Organization Active NPI Dermatology Physician · Melrose, MA

NPI 1013678747 · NPPES record last updated Jan 5, 2022

Key facts

NPI
1013678747
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
ADVANCED DERMATOLOGY OF MELROSE, PLLC
Practice address
802 Main St
Melrose, MA 02176-2708
Phone
(978) 371-7010
NPI assigned
Jan 5, 2022
Organization subpart
Yes
Parent organization (as reported)
STEVEN I. KORNBLEUTH, MD

Authorized official

Name
Samuel Goos
Title
Owner
Phone
(978) 371-7010

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Part of
Steven Ira Kornbleuth

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207N00000X Yes

Addresses

Primary practice location

802 Main St
Melrose, MA 02176-2708

Mailing address

526 Main St Ste 302
Acton, MA 01720-3301
Phone (978) 371-7010

Other providers in Melrose, MA

All providers in Melrose, MA · Dermatology Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.