Avant-Garde Medical LLC

Organization Active NPI Dermatology Physician · Natick, MA

NPI 1679098750 · NPPES record last updated Aug 9, 2017

Key facts

NPI
1679098750
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
AVANT-GARDE MEDICAL LLC
Practice address
62 Pleasant St
Natick, MA 01760-5634
Phone
(508) 238-8646
NPI assigned
Aug 9, 2017
Organization subpart
No

Authorized official

Name
Fariba Miryousefi
Title
Owner
Phone
(508) 238-8646

Practitioners 1

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

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

62 Pleasant St
Natick, MA 01760-5634

Mailing address

35 United Dr Ste 102
W Bridgewater, MA 02379-1027
Phone (508) 238-8646

Other providers in Natick, MA

All providers in Natick, MA · Dermatology Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.