Id of Plymouth LLC
NPI #1134896467 in Plymouth, Massachusetts
Provider Information
- NPI Number
- 1134896467
- Entity Type
- Organization
- Organization Name
- Id of Plymouth LLC
- Primary Specialty
- Dermatology
- Enumeration Date
- Aug 25, 2021
- Last Updated
- Aug 25, 2021
Practice Location
- Address
- 110 LONG POND RD STE 202
- City
- Plymouth
- State
- Massachusetts
- ZIP Code
- 02360-2642
- Phone
- (508) 747-4424
Authorized Official
- Name
- JENNIFER T HALEY, MD
- Title
- AUTHORIZED GROUP OFFICIAL
- Phone
- (561) 314-2000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology |
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