CONNECTICUT SKIN INSTITUTE (NPI# 1013263847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013263847 |
Entity Type | Organization |
Organization Name | CONNECTICUT SKIN INSTITUTE |
Practice Address |
999 Summer St Suite 205 Stamford CT 06905-5546 |
Practice Telephone | 9173013781 |
Mailing Telephone | 9173013781 |
Enumeration Date | 2012-07-30 |
Last Update Date | 2013-09-25 |
Authorized Official Name | OMAR A IBRAHIMI (OWNER) |
Authorized Official Telephone | 9173013781 |
Authorized Official Credential | MD PHD LLC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
049530 | CT | Allopathic & Osteopathic Physicians |
Street Address |
999 SUMMER ST SUITE 205 |
City | STAMFORD |
State | CT |
Zip Code | 06905-5546 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609856020 | James Tulacro | Physician Assistant | 999 Summer St, 304, Stamford, CT 06905-5546 | 2006-01-20 |
1598222119 | Lubna Latif | Physician Assistant | 999 Summer St, Stamford, CT 06905-5546 | 2019-03-01 |
1750815098 | Mary Coppolo | Nurse Practitioner | 999 Summer St, Suite 304, Stamford, CT 06905-5546 | 2017-04-13 |
1578937579 | Integrative Medical Solutions, PC | Physical Medicine & Rehabilitation | 999 Summer St, Suite 205, Stamford, CT 06905-5546 | 2015-11-15 |
1700256708 | Big Leaps | Occupational Therapist | 999 Summer St, Suite 104, Stamford, CT 06905-5546 | 2015-10-02 |
1346649589 | Mark J. Ostrowski, Psy.d. LLC | Psychologist | 999 Summer St, Suite 200, Stamford, CT 06905-5546 | 2014-08-13 |
1962849091 | Comprehensive Neurology and Pain Center of Connecticut (stamford) | Pain Medicine | 999 Summer St, Suite 100, Stamford, CT 06905-5546 | 2013-05-30 |
1033472568 | Shimrat R Notik | Dermatology | 999 Summer St, Ste 305, Stamford, CT 06905-5513 | 2012-06-19 |
1306156385 | Danielle Mckay | Occupational Therapy Assistant | 999 Summer St, Suite 104, Stamford, CT 06905-5546 | 2010-10-08 |
1568770428 | Gold Coast Plastic Surgery and Laser Center, LLC | Plastic Surgery | 999 Summer St, Suite 401, Stamford, CT 06905-5546 | 2010-09-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396367272 | Smartport LLC | Non-emergency Medical Transport (VAN) | C/o Mollo, 1111 Summer St, Stamford, CT 06905 | 2020-05-13 |
1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
1871150409 | Connecticut Anesthesia Associates LLC | Anesthesiology | 1177 High Ridge Road, Stamford, CT 06905 | 2019-05-20 |
1518447887 | Alexandra Petrov | Lactation Consultant, Non-RN | 42 Riverside Ave, Stamford, CT 06905 | 2018-08-16 |
1235640327 | A&s Chemists LLC | Pharmacy | 910 Summer Ave, Stamford, CT 06905 | 2017-10-17 |
1659805117 | Evolution Physical Therapy, LLC | Clinic/Center | 7 Reynolds Ave, Stamford, CT 06905 | 2017-04-11 |
1326587841 | Karen Poggi | Speech-Language Pathologist | 30 Buxton Farm Rd., Suite 230, Stamford, CT 06905 | 2017-02-16 |
1811434871 | Christina Skuburids, LLC | Point of Service | 2043 Bedford Street, Stamford, CT 06905 | 2017-01-27 |
1669833513 | Christian Alvarez | Occupational Therapist | 15 First St Unit 1, Stamford, CT 06905 | 2016-03-18 |
1932500915 | Emily Krol | Psychologist | 29 Yale Court, Stamford, CT 06905 | 2014-09-10 |
Find all providers in zip 06905 |
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 |
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 |
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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.