ESSEX DERMATOLOGY LLC (NPI# 1043378508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043378508 |
| Entity Type | Organization |
| Organization Name | ESSEX DERMATOLOGY LLC |
| Practice Address |
20 Saybrook Road Essex CT 06426-1401 |
| Practice Telephone | 8607679998 |
| Practice Fax Number | 8607679161 |
| Mailing Telephone | 8607679998 |
| Mailing Fax Number | 8607679161 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | DR. VIRGINIA L MAHER WIESE (OWNER) |
| Authorized Official Telephone | 8607679998 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | MEDICARE ID - GROUP | C03091 | 01 |
| Street Address |
20 SAYBROOK ROAD |
| City | ESSEX |
| State | CT |
| Zip Code | 06426-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396700217 | Virginia L Maher Wiese | Dermatology | 20 Saybrook Road, Essex, CT 06426-1401 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123867 | Art Therapy & Creative Counseling | Counselor | 80 Plains Rd Unit 1, Essex, CT 06426 | 2017-06-05 |
| 1487085593 | Catherine Mary Demers | Nurse Practitioner | 10 Wildwood Medical Center, Essex, CT 06426 | 2013-11-29 |
| 1346515723 | Anne Peterson | Counselor | 80 Plains Rd, Essex, CT 06426 | 2012-03-19 |
| 1477851731 | Diana Leigh Amara | Counselor | 80 Plains Road, Essex, CT 06426 | 2011-03-09 |
| 1609034438 | Marybeth Pytlik Ellison | Pediatrics | Sunflower Developmental Pediatrics, 11 Wildwood Medical Center, Essex, CT 06426 | 2008-05-29 |
| 1780749747 | Dana Lyn Martin | Counselor | 190 Westbrook Road, Essex Child Guidance Clinic, Essex, CT 06426 | 2006-12-27 |
| 1881768836 | Jason Christopher Andrade | Counselor | 190 Westbrock Rd, Essex, CT 06426 | 2006-11-20 |
| 1386735546 | Robert D Dwyer | Urology | 6 Wildwood Medical Center, Essex, CT 06426 | 2006-09-27 |
| 1154421071 | Sharon D Mallon | Psychologist | 251 Westbrook Rd, Essex, CT 06426 | 2006-09-22 |
| 1043319510 | Brian David Fay | Social Worker | 251 Westbrook Road, Essex, CT 06426 | 2006-09-21 |
| Find all providers in zip 06426 | ||||
| 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 |
|---|---|---|---|---|
| 1396700217 | Virginia L Maher Wiese | Dermatology | 20 Saybrook Road, Essex, CT 06426-1401 | 2006-04-20 |
| 1720333487 | Lynn M Smith | Dermatology | 20 Saybrook Rd, Essex, CT 06426-1401 | 2012-07-18 |
| 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.