CANTON DERMATOLOGY CLINIC, INC (NPI# 1295819290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295819290 |
| Entity Type | Organization |
| Organization Name | CANTON DERMATOLOGY CLINIC, INC |
| Practice Address |
95 Washington St Canton MA 02021-4006 |
| Practice Telephone | 7818212888 |
| Practice Fax Number | 7818218684 |
| Mailing Telephone | 7818212888 |
| Mailing Fax Number | 7818218684 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2014-08-11 |
| Authorized Official Name | JAFAR KOUPAIE (PRESIDENT) |
| Authorized Official Telephone | 7818212888 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
| Street Address |
95 WASHINGTON ST |
| City | CANTON |
| State | MA |
| Zip Code | 02021-4006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326039017 | Richard Hemingway | Physical Therapist | 95 Washington St, Canton, MA 02021-4006 | 2005-11-02 |
| 1316425515 | Shadi Karam Haidar | Dentist | 95 Washington St, Canton, MA 02021-4006 | 2018-07-31 |
| 1346787090 | Partners Urgent Care, LLC | Clinic/Center | 95 Washington St, Canton, MA 02021-4006 | 2017-01-19 |
| 1154770030 | Sandzhar Yusupov | Contractor | 95 Washington St, Ste #474, Canton, MA 02021-4006 | 2016-06-10 |
| 1194188292 | Samuel Wonil Chang | Pharmacist | 95 Washington St, Canton, MA 02021-4006 | 2016-04-05 |
| 1366803413 | Danielle M Smith | Physical Therapist | 95 Washington St, Canton, MA 02021 | 2016-03-17 |
| 1750741120 | Lauren Decouto | Pharmacist | 95 Washington St, Canton, MA 02021-4006 | 2016-02-29 |
| 1497110647 | Pinali Gandhi | Physical Therapist | 95 Washington St, Ste 462, Canton, MA 02021-4006 | 2015-12-15 |
| 1285040170 | Mansi Parikh | Physical Therapist | 95 Washington St, 462, Canton, MA 02021-4006 | 2014-07-11 |
| 1013323716 | Jessica Christine Lariviere | Physical Therapist | 95 Washington St, Ste 462, Canton, MA 02021-4006 | 2014-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265931331 | Faith Alpiche Felitto | Registered Nurse | 9 Bay Drive, Apt 113, Canton, MA 02021 | 2018-02-05 |
| 1184122103 | Mind Compass, LLC | Counselor | 45 Dan Road, C/o Workspace@45, Suite 19, Canton, MA 02021 | 2018-01-24 |
| 1861903353 | Daphnis Colin | Registered Nurse | 211 Bay Drive, Canton, MA 02021 | 2017-10-24 |
| 1245772276 | Rebecca Selenow | Counselor | 10 Emerson Rd, Canton, MA 02021 | 2016-11-08 |
| 1407398449 | Brightview Canton LLC | Alzheimer Center (Dementia Center) | 125 Turnpike Street, Canton, MA 02021 | 2016-11-08 |
| 1699144014 | Marguerite Hobbs | Social Worker | 55 Pecunit St, Canton, MA 02021 | 2015-09-15 |
| 1447662234 | Cornerstone At Canton Assisted Living LLC | Assisted Living Facility | 175 Revere Street, Canton, MA 02021 | 2014-05-28 |
| 1508100157 | Greystone Pain Management Inc | Psychiatry & Neurology | 21 Rockland St, Unit M, Canton, MA 02021 | 2012-11-20 |
| 1457678062 | Smile Designs Inc | Dentist | 95 Washington St # 480, Smile Designs Inc, Canton, MA 02021 | 2010-04-23 |
| 1114178803 | Jennifer Diana Marie Woodbury | Specialist/Technologist | 1 Whitman Road, Clarke School East, Canton, MA 02021 | 2008-10-01 |
| Find all providers in zip 02021 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508940644 | Jafar Koupaie | Dermatology | 95 Washington St, Canton, MA 02021-4006 | 2006-10-25 |
| 1538117866 | Iltefat H Hamzavi | Dermatology | 285 N Lilley Rd, Canton, MI 48187-3907 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341362 | Gary Mendese, Md, LLC | Dermatology | 23 Centennial Dr, Peabody, MA 01960-7901 | 2020-06-23 |
| 1053811430 | Leigh Melanson-adams | Dermatology | 382 Lowell St, Wakefield, MA 01880-1972 | 2018-02-13 |
| 1578073128 | Karen Carreiro | Dermatology | 775 Davol St Ste 3, Fall River, MA 02720-1028 | 2017-10-10 |
| 1225458185 | Prasanthi Kandula | Dermatology | 1244 Boylston St, Chestnut Hill, MA 02467 | 2014-04-18 |
| 1538500988 | Skin Wellness Physicians, LLC | Dermatology | 85 Herrick St, Beverly Hospital Oncology Center, Beverly, MA 01915-1790 | 2013-07-15 |
| 1689012510 | Dennis Anthony Porto | Dermatology | 1 Maple Street, 2nd Floor, Milford, MA 01757 | 2013-06-13 |
| 1518204353 | Newton Watertown Dermatology Associates | Dermatology | 280 Washington St, Suite #212, Brighton, MA 02135-3511 | 2013-01-14 |
| 1922373018 | Frank R Vleugels | Dermatology | 221 Longwood Ave, Boston, MA 02115-5804 | 2012-03-21 |
| 1174729628 | Dermatology Consultants At Newton-wellesley PC | Dermatology | 2000 Washington St, B120, Newton Lower Falls, MA 02462-1602 | 2007-06-22 |
| 1093919078 | Dermatology and Laser Center of Western Mass Inc | Dermatology | 75 Post Office Park, Suite 7501, Wilbraham, MA 01095-1188 | 2007-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.