Id of Massachusetts LLC
NPI #1477229326 in Quincy, Massachusetts
Provider Information
- NPI Number
- 1477229326
- Entity Type
- Organization
- Organization Name
- Id of Massachusetts LLC
- Primary Specialty
- Dermatology
- Enumeration Date
- Aug 20, 2021
- Last Updated
- Jan 27, 2026
Practice Location
- Address
- 104 QUARRY ST STE 2
- City
- Quincy
- State
- Massachusetts
- ZIP Code
- 02169-4174
- Phone
- (617) 472-6764
Authorized Official
- Name
- JENNIFER L JACKSON
- Title
- AUTHORIZED OFFICIAL
- Phone
- (561) 223-8081
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology |
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