Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Id of Quincy LLC

Organization Dermatology Physician · NPI 1053088377

Id of Quincy LLC is a Dermatology Physician in Quincy, Massachusetts. Works from 2 locations. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

104 Quarry St Ste 2
Quincy, MA 02169-4174
Phone: (617) 472-6764
Fax: (617) 770-9933
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 40 Industrial Park Rd Ste 202, Plymouth, MA 02360-4884 — (617) 472-6764

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1053088377
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Haley — Authorized Group Official · (561) 314-2000
NPI enumeratedAugust 25, 2021
Last updated in NPPESJanuary 27, 2026
Certification dateJanuary 27, 2026
Mailing address4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450

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