ON SITE DERMATOLOGY OF CONNECTICUT LLC (NPI# 1326473661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326473661 |
| Entity Type | Organization |
| Organization Name | ON SITE DERMATOLOGY OF CONNECTICUT LLC |
| Practice Address |
902 Clint Moore Rd Suite 226 Boca Raton FL 33487-2800 |
| Practice Telephone | 5613142000 |
| Practice Fax Number | 5614318199 |
| Mailing Telephone | 5613142000 |
| Mailing Fax Number | 5614318199 |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |
| Authorized Official Name | GERRY CHRISTOPHER (ADMINISTRATOR) |
| Authorized Official Telephone | 5613142000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
902 CLINT MOORE RD SUITE 226 |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33487-2800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548221963 | Mei Mei Chan | Physician Assistant | 902 Clint Moore Rd, Ste 227, Boca Raton, FL 33487-2800 | 2006-03-28 |
| 1114380441 | Nancy Fox-goughan | Dental Hygienist | 902 Clint Moore Rd, Boca Raton, FL 33487-2800 | 2016-04-04 |
| 1871968842 | New York Senior Dermatology Pllc | Dermatology | 902 Clint Moore Rd, Suite 227, Boca Raton, FL 33487-2800 | 2015-12-02 |
| 1306227269 | Reliable Documents Solutions, LLC | Specialist/Technologist, Other | 902 Clint Moore Rd, Ste 114, Boca Raton, FL 33487-2800 | 2015-06-16 |
| 1710373352 | On Site Dermatology of South Carolina LLC | Dermatology | 902 Clint Moore Rd, Suite 227, Boca Raton, FL 33487-2800 | 2015-04-10 |
| 1811389539 | On Site Dermatology of New Jersey, LLC | Dermatology | 902 Clint Moore Rd, Suite 227, Boca Raton, FL 33487-2800 | 2015-03-04 |
| 1124437041 | On Site Dermatology of Maine LLC | Dermatology | 902 Clint Moore Rd, Suite 227, Boca Raton, FL 33487-2800 | 2014-08-05 |
| 1801217864 | On Site Dermatology of Massachusetts, LLC | Dermatology | 902 Clint Moore Rd, 227, Boca Raton, FL 33487-2800 | 2013-12-18 |
| 1558796680 | Casey Courcy | Nurse Practitioner | 902 Clint Moore Rd, Suite 227, Boca Raton, FL 33487-2800 | 2013-09-09 |
| 1558639757 | Jag Lab LLC | Clinical Medical Laboratory | 902 Clint Moore Rd, Suite 225, Boca Raton, FL 33487-2800 | 2011-12-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386261741 | Kendall Hackenberg | Nurse Practitioner | 810 Nw 82nd Pl, Boca Raton, FL 33487 | 2020-07-01 |
| 1275187015 | Trusted Home Care Agency | Home Health | 1200 S. Rogers Circle, Suite #4, Boca Raton, FL 33487 | 2019-07-30 |
| 1972064475 | West Palm Beac Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 902 Clint Moore Road, Ste 144, Boca Raton, FL 33487 | 2019-03-27 |
| 1386153807 | Michael Christopher Angelillo | Internal Medicine | 1601 Clint Moore Rd Ste 115, Boca Raton, FL 33487 | 2017-09-27 |
| 1942729645 | Ronald Falk | Chiropractor | 6201 N Federal Hwy #5-6, Boca Raton, FL 33487 | 2017-09-13 |
| 1205292653 | Abigail Goodwin Sladek | Nurse Practitioner | 902 Clint Moore Rd # 227, Boca Raton, FL 33487 | 2016-01-14 |
| 1538539879 | Nancy Gonzalez | Dental Hygienist | 904 Clint Moore Rd, Boca Raton, FL 33487 | 2015-09-29 |
| 1083090138 | John Hooper Griscom | Internal Medicine | 3752 Mykonos Court, Boca Raton, FL 33487 | 2015-07-30 |
| 1144600321 | Hear Again LLC | Audiologist-Hearing Aid Fitter | 851 Broken Sound Pkwy Nw Ste 120, Boca Raton, FL 33487 | 2015-06-03 |
| 1457759193 | Element Lab Partners, LLC | Clinical Medical Laboratory | 1101 Holland Dr., Ste. 30, Boca Raton, FL 33487 | 2014-12-11 |
| Find all providers in zip 33487 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1770144123 | Mobile Dermatology Care Pllc | Dermatology | 4700 Exchange Ct Ste 110, Boca Raton, FL 33431-4450 | 2019-06-26 |
| 1790171353 | Eric Rudnick | Dermatology | 22029 State Road 7 Ste 1, Boca Raton, FL 33428-4200 | 2015-04-10 |
| 1649616970 | Moum Dermatology LLC | Dermatology | 445 S Federal Hwy, Boca Raton, FL 33432-6027 | 2013-05-14 |
| 1114361235 | Dermpartners Inc | Dermatology | 21020 State Rd 7, Suite 120, Boca Raton, FL 33428 | 2013-04-19 |
| 1831410315 | Kenneth Jon Folsom | Dermatology | 3902 Nw 23rd Ct, Boca Raton, FL 33431-5446 | 2010-06-18 |
| 1588810808 | Lloyd George Wickboldt | Dermatology | 6630 Patio Ln, Boca Raton, FL 33433-6631 | 2008-08-18 |
| 1417115304 | Channing Rachel Barnett | Dermatology | 7100 W Camino Real Ste 301, Boca Raton, FL 33433-5510 | 2008-05-28 |
| 1164626545 | Patricia Sara Klem | Dermatology | 1905 Clint Moore Rd. Ste. 103, Advanced Dermatology, Boca Raton, FL 33496 | 2007-06-12 |
| 1255545547 | John Alan Kulick | Dermatology | 22804 Marbella Circle, Boca Raton, FL 33433-3802 | 2007-05-09 |
| Find all providers in BOCA RATON | ||||
| City | BOCA RATON |
| Zip Code | 33487 |
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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.