Eastern Connecticut Dermatology Pc in Groton - Specialist
Eastern Connecticut Dermatology Pc - NPI 1760604961
Eastern Connecticut Dermatology Pc is a Specialist in Groton, Connecticut. Eastern Connecticut Dermatology Pc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Eastern Connecticut Dermatology Pc is 1760604961. The last update date is 2013-11-25.
Eastern Connecticut Dermatology Pc's current location address is 491 Gold Star Hwy, Groton, Connecticut. You can contact this provider via phone number 8604458020 and fax number 8604451665. The mailing address for Eastern Connecticut Dermatology Pc is 491 Gold Star Hwy, Groton, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eastern Connecticut Dermatology Pc |
|---|---|
| Address | 491 Gold Star Hwy, Groton, Connecticut |
| Phone Number | 8604458020 |
| Fax Number | 8604451665 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Davidson M Diane |
| Credentials | M.D. |
| Telephone Number | 8604458020 |
NPI Number Detail
| NPI Number | 1760604961 |
|---|---|
| Provider Enumeration Date | 2007-05-03 |
| Last Updated Date | 2013-11-25 |
Provider Mailing Address Detail
| Address | 491 Gold Star Hwy |
|---|---|
| City | Groton |
| State | Connecticut (CT) |
| Post Code | 63406226 |
| Phone Number | 8604458020 |
| Fax Number | 8604451665 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 25536 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1255363 | CT | -- | |
| 1233204 | CT | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Eastern Connecticut Dermatology Pc by the Centers for Medicare & Medicaid Services?
The Eastern Connecticut Dermatology Pc has been issued the NPI (National Provider Identifier) 1760604961 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Eastern Connecticut Dermatology Pc is physically located?
The Eastern Connecticut Dermatology Pc is physically situated at the following address: 491 Gold Star Hwy, Groton, CT, 63406226.
What is Eastern Connecticut Dermatology Pc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Eastern Connecticut Dermatology Pc is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
On what date did Eastern Connecticut Dermatology Pc receive its 1760604961 assignment from the Centers for Medicare & Medicaid Services?
The Eastern Connecticut Dermatology Pc was assigned its 1760604961 on 2007-05-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Eastern Connecticut Dermatology Pc's information last updated?
The Eastern Connecticut Dermatology Pc's information was last updated on 2013-11-25.