NELLIE KONNIKOV (NPI# 1376646638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376646638 |
Entity Type | Individual |
Full Name | NELLIE KONNIKOV |
Credential | MD |
Practice Address |
150 S Hungtington Ave Boston MA 02130 |
Mailing Address |
150 S Hungtington St Boston MA 02130 |
Practice Telephone | 8573644757 |
Practice Fax Number | 8573646604 |
Mailing Telephone | 8573644757 |
Mailing Fax Number | 8573646604 |
Enumeration Date | 2006-09-05 |
Last Update Date | 2012-08-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207N00000X | Dermatology | $$$$$$$$$ | MA | Allopathic & Osteopathic Physicians |
Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
50447 | MA | Allopathic & Osteopathic Physicians |
Street Address |
150 S HUNGTINGTON AVE |
City | BOSTON |
State | MA |
Zip Code | 02130 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952913121 | Virginia Dawn Pratt | Social Worker | Ethos, 555 Amory Street, Jamaica Plain, MA 02130 | 2020-08-19 |
1689139917 | Lina Skiba | Speech-Language Pathologist | Thom Child & Family Services, 555 Armory St, Jamaica Plain, MA 02130 | 2019-01-31 |
1841775442 | Melissa Rocklen | Social Worker | 30 Germania St Bldg C, Jamaica Plain, MA 02130 | 2018-09-28 |
1902389281 | Susan N. Berkman | Social Worker | 111 Perkins St., Apt.120, Jamaica Plain, MA 02130 | 2018-09-12 |
1326551912 | Cindy Tromp | Counselor | Arbour Hospital, 49 Robinwood Ave, Jamaica Plain, MA 02130 | 2017-11-06 |
1811415128 | Jesse Myles Carmen | Social Worker | 555 Armory Street, Jamaica Plain, MA 02130 | 2017-09-07 |
1881119410 | Melanie Suzanne Witman | Counselor | 1125 Centre Street, Boston, MA 02130 | 2017-08-04 |
1740702125 | Farah Clermont | Counselor | 3815 Washington St., Jamaica Plain, MA 02130 | 2017-07-07 |
1346777554 | Anjalie L Pieres | Counselor | 157 Green Streey, Jamaica Plain, MA 02130 | 2017-05-18 |
1316480098 | Caroline Amina Shaw-moss | Counselor | 7 Burr St., Boston, MA 02130 | 2016-11-29 |
Find all providers in zip 02130 |
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 |
---|---|---|---|---|
1922373018 | Frank R Vleugels | Dermatology | 221 Longwood Ave, Boston, MA 02115-5804 | 2012-03-21 |
1528012176 | Pratt Med/surg Dermatology Associates Inc | Dermatology | 800 Washington St, Box 1013, Boston, MA 02111-1552 | 2006-05-19 |
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 |
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 |
1760698187 | Ayer Dermatology P.C. | Dermatology | 190 Groton Rd, Ayer, MA 01432-1124 | 2007-05-15 |
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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.