CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC


Address: 2928 Main St Ste 100, Glastonbury, CT 06033-1007
Phone: (860) 633-2332

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
CT MEDICAL LICENSE 040694 01
DEA FC2314881 01
NPI 1790888584 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
499 Farmington Ave Ste 230, Farmington, CT 060321933 8606761900 8604090602

Office Location

Street Address 2928 MAIN ST STE 100
City GLASTONBURY
State CT
Zip Code 06033-1007

Providers in the same zip code

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 Information

Taxonomy Code 207ND0101X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization MOHS-Micrographic Surgery

Taxonomy Definition

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/

Providers in the same taxonomy and state

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

Competitor

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City GLASTONBURY
Zip Code 06033

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Dataset Information

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.

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