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Contact Information

DEROSA FACIAL PLASTIC SURGERY PC
91 NEWBURY ST
SUITE 300
BOSTON, MA02116-3084
 Phone: 617-262-8000
 Fax: 617-262-8002
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for DEROSA FACIAL PLASTIC SURGERY PC · (Female)

NPI # 1164867479
Status Active
Credentials
Entity Individual
Enumeration date 05/01/2013
Last updated 10/15/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # 237016
  • Other 0032529 MEDICARE GROUP PTAN
  • Other 000755302 MEDICARE PROVIDER PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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