CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC (NPI# 1407374481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407374481 |
Entity Type | Organization |
Organization Name | CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC |
Practice Address |
2928 Main St Ste 100 Glastonbury CT 06033-1007 |
Practice Telephone | (860) 633-2332 |
Practice Fax Number | 8606332352 |
Mailing Telephone | 8606332332 |
Mailing Fax Number | 8606332352 |
Enumeration Date | 2017-08-30 |
Last Update Date | 2018-03-17 |
Authorized Official Name | CHRISTINE GIGLIO (PRACTICE MANAGER) |
Authorized Official Telephone | 8606761900 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207N00000X | Dermatology | 040694 | CT | Allopathic & Osteopathic Physicians |
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
040694 | CT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | MEDICAL LICENSE | 040694 | 01 |
DEA | FC2314881 | 01 | |
NPI | 1790888584 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
499 Farmington Ave Ste 230, Farmington, CT 060321933 | 8606761900 | 8604090602 |
Street Address |
2928 MAIN ST STE 100 |
City | GLASTONBURY |
State | CT |
Zip Code | 06033-1007 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477074649 | Starling Physicians, PC | Durable Medical Equipment & Medical Supplies | 289 Western Blvd, Glastonbury, CT 06033 | 2017-06-28 |
1497284897 | D&l Eyecare | Optometrist | 33 Welles Street, Glastonbury, CT 06033 | 2017-06-08 |
1730626235 | Half Full Psychiatry LLC | Clinic/Center | 39 New London Tpke Ste 230f, Glastonbury, CT 06033 | 2017-01-23 |
1285000117 | Olga A Levkina | Physician Assistant | 2928 Main St Ste 101, Glastonbury, CT 06033 | 2015-08-14 |
1619350576 | Ryan Ilg Reichelt | Dentist | 131 New London Tpke Ste 211, Glastonbury, CT 06033 | 2015-07-09 |
1316320534 | Devon Banda | Orthopaedic Surgery | The Hand Center, 195 Eastern Blvd, # 200, Glastonbury, CT 06033 | 2015-07-07 |
1881073195 | Brittney Stanley | Counselor | 122 Naubuc Ave Ste 104, Glastonbury, CT 06033 | 2015-05-20 |
1780071878 | Richard T. Risinger | Dentist | 88 Citizens Drive, Glastonbury, CT 06033 | 2015-04-16 |
1639568751 | Carol Jane Gammell | Counselor | 140 Glastonbury Boulevard, Suite 30, Glastonbury, CT 06033 | 2015-01-13 |
1407262611 | Prashant Sinha | Dentist | 2874 Main Street, Glastonbury, CT 06033 | 2014-07-08 |
Find all providers in zip 06033 |
Taxonomy Code | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376575324 | John R. West Md Inc | Dermatology | 34 Water St, Suite 2, Mystic, CT 06355-2524 | 2006-07-07 |
1497795314 | Barry J Richter | Dermatology | 5 Durham Road, Guilford, CT 06437 | 2006-06-08 |
1437198702 | Andrew M Herbst | Dermatology | 13 Park St, Norwalk, CT 06851-4811 | 2006-06-05 |
1013263847 | Connecticut Skin Institute | Dermatology | 999 Summer St, Suite 205, Stamford, CT 06905-5546 | 2012-07-30 |
1588859946 | Dermatology Surgical Associates, LLC | Dermatology | 499 Farmington Ave, Suite 230, Farmington, CT 06032-1933 | 2007-09-10 |
1487606117 | John Robert West Jr. | Dermatology | 34 Water Street, Suite 2, Mystic, CT 06355 | 2006-05-17 |
City | GLASTONBURY |
Zip Code | 06033 |
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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.