On Site Dermatology of Massachusetts, LLC
Organization Active NPI Dermatology Physician · Harvard, MA
NPI 1801217864 · NPPES record last updated Apr 18, 2025
Key facts
- NPI
- 1801217864
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- ON SITE DERMATOLOGY OF MASSACHUSETTS, LLC
- Practice address
- 39 E Bare Hill Rd
Harvard, MA 01451-1852 - Phone
- (877) 345-5300
- NPI assigned
- Dec 18, 2013
- Organization subpart
- No
Authorized official
- Name
- Jeffrey D. Queen
- Title
- Owner
- Phone
- (561) 314-2000
Practitioners 27
-
Andreann Huang, NP
-
Raichel Topale, NP
-
Christine Kannler, M.D., M.P.H.
-
Madeleine Mary Gamache, PA-C
-
Michael A Tomeo, MD
-
Louise Abraham, PT
-
Frances Brier, MPT
-
Gail Allison Dannenfels, OTR/L
-
Jenna Haddad, DPT
-
William J Howley, PT
-
Katherine Kalinowski, OTR
-
Rujal Kansara, PHYSICAL THERAPIST
-
Viral Landsman, M.S. CCC-SLP
-
Amy Wajda, OT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141017000050 | MA | Part B Supplier - Clinic/Group Practice | 0941421812 | Receives reassigned benefits from 7 practitioners |
National Provider Directory
Locations
4700 Exchange Ct
Boca Raton, FL 33431
Phone (561) 862-0051
10 Pelham Rd
Lexington, MA 02421
Phone (781) 861-3535
2 Technology Dr
Lowell, MA 01851
55 Salem St
Lynnfield, MA 01940
Phone (781) 245-0668
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
39 E Bare Hill Rd
Harvard, MA 01451-1852
Mailing address
4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000
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All providers in Harvard, MA · Dermatology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.