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Derosa Facial Plastic Surgery Pc
Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Boston, Massachusetts
NPI 1164867479

Derosa Facial Plastic Surgery Pc is a Plastic Surgery within the Head & Neck (Otolaryngology) Physician based in Boston, MA and is specialized in Plastic Surgery within the Head & Neck. Derosa Facial Plastic Surgery Pc practices in Boston, MA. The NPI Number for Derosa Facial Plastic Surgery Pc is 1164867479 and holds a License No. 237016 (Massachusetts).

The current practice location address for Derosa Facial Plastic Surgery Pc is 91 Newbury St, Boston, MA and can be reached out via phone at 617-262-8000 and via fax at 617-262-8002.

Location: 91 Newbury St, Boston, MA, 02116-3084
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164867479
Provider Name
Derosa Facial Plastic Surgery Pc
Credential
Provider Entity Type
Organization
Address
91 Newbury St, Boston, MA, 02116-3084
Phone Number
617-262-8000
Fax Number
617-262-8002
Provider Enumeration Date
05/01/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0032529 01 MEDICARE GROUP PTAN
000755302 01 MEDICARE PROVIDER PTAN
institution
Provider Business Practice Location Address Details
Address
91 Newbury St
City
Boston
State
Massachusetts
Zip
02116-3084
Phone Number
617-262-8000
Fax Number
617-262-8002
person
Provider Business Mailing Address Details
Address
91 Newbury St
City
Boston
State
Massachusetts
Zip
02116-3084
Phone Number
617-262-8000
Fax Number
617-262-8002
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
Plastic Surgery within the Head & Neck
Taxonomy
207YX0007X
License No.
237016 (Massachusetts)
Definition
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
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