ANNETTE L HEADLEY MD LLC (NPI# 1568772242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568772242 |
| Entity Type | Organization |
| Organization Name | ANNETTE L HEADLEY MD LLC |
| Practice Address |
56 Whitehall Ave Mystic CT 06355-1978 |
| Practice Telephone | 8605361354 |
| Practice Fax Number | 8605367043 |
| Mailing Telephone | 8605361354 |
| Mailing Fax Number | 8605367043 |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-11-09 |
| Authorized Official Name | DR. ANNETTE L HEADLEY (PROPRIETOR/PHYSICIAN) |
| Authorized Official Telephone | 8605361354 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 034245 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | PERSONAL NPI NUMBER | 1295841682 | 01 |
| Street Address |
56 WHITEHALL AVE |
| City | MYSTIC |
| State | CT |
| Zip Code | 06355-1978 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154347250 | Edmund A P West | Internal Medicine | 56 Whitehall Ave, Rt 27, Mystic, CT 06355 | 2006-07-14 |
| 1487770228 | J. Andrew Hallberg, Md, LLC | Specialist | 56 Whitehall Ave, Suite A, Mystic, CT 06355-1967 | 2007-03-22 |
| 1881780773 | Seaport Clinic LLC | Internal Medicine | 56 Whitehall Ave, Rt 27, Mystic, CT 06355 | 2006-10-05 |
| 1881610970 | Anne Maria Timmerman | Internal Medicine | 56 Whitehall Ave, Rt 27, Mystic, CT 06355 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770076069 | Brian Kristofer Owczarski | Physical Therapist | 80 Stonington Rd Ste A-3, Mystic, CT 06355 | 2018-06-11 |
| 1922554120 | Kayla Nickerson Gauthier | Marriage & Family Therapist | 41 Williams Ave, Mystic, CT 06355 | 2016-08-28 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1619386539 | Jennifer Rock | Occupational Therapist | 44 Maritime Drive, Pendleton Health and Rehab Center, Mystic, CT 06355 | 2014-08-05 |
| 1346565843 | Karen Lucille Hanscom | Psychologist | 47 Water St. #203, Mystic, CT 06355 | 2010-03-29 |
| 1346415627 | Eldon Richard Kilpatrick | Physical Therapy Assistant | 186 Jerry Browne Rd, Mystic, CT 06355 | 2008-04-28 |
| 1760688931 | Heather Elyse Geyer | Physical Therapist | 2440 Gold Star Hwy Suite 201, Mystic, CT 06355 | 2007-06-25 |
| 1982728754 | Falck Eye Center LLC | Ophthalmology | 35 Washington Street, Mystic, CT 06355 | 2007-03-19 |
| 1881724326 | Richard Irwin Steinberg | Dentist | 117 Cow Hill Road, Mystic, CT 06355 | 2007-03-06 |
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| Find all providers in zip 06355 | ||||
| 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 |
|---|---|---|---|---|
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| 1295841682 | Annette Lupinacci Headley | Dermatology | 56 Whitehall Avenue, Mystic, CT 06355 | 2006-08-21 |
| 1174594279 | Daniella Duke | Dermatology | 55 Willow St, Mystic, CT 06355-2636 | 2006-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477175966 | Young Skin | Dermatology | 1111 Summer St, Stamford, CT 06905-5508 | 2020-05-07 |
| 1922633213 | The Dermatology Center of Connecticut, LLC | Dermatology | 60 Church St Unit 4b, Wallingford, CT 06492-2340 | 2020-03-06 |
| 1063055853 | Integrated Dermatology of Vernon, Pllc | Dermatology | 357 Hartford Tpke Fl 2, Vernon, CT 06066-4838 | 2019-10-24 |
| 1023663424 | Dermatology Solutions, LLC | Dermatology | 35 E Main St Ste 118, Avon, CT 06001-3845 | 2019-08-03 |
| 1407374481 | Center for Skin Surgery & Dermatology, Pllc | Dermatology | 2928 Main St Ste 100, Glastonbury, CT 06033-1007 | 2017-08-30 |
| 1962933572 | Daniel Mark Klufas | Dermatology | 64 Tuckahoe Rd, Easton, CT 06612-2054 | 2017-03-24 |
| 1912446782 | Associates In Medical & Cosmetic Dermatology, PC | Dermatology | 9 Washington Avenue, Hamden, CT 06518 | 2017-02-14 |
| 1457728883 | Integrated Dermatology of Clinton,llc | Dermatology | 8 E Main St Ste 101, Clinton, CT 06413-2058 | 2015-09-02 |
| 1760873210 | Nicholas V Perricone | Dermatology | 639 Research Pkwy, Meriden, CT 06450-7154 | 2015-02-05 |
| 1497160535 | Dean David George | Dermatology | 399 Farmington Ave Ste 260, Farmington, CT 06032-1979 | 2014-06-27 |
| Find all providers with the same taxonomy | ||||
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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.