THE DERMATOLOGY CENTER OF CONNECTICUT, LLC (NPI# 1922633213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922633213 |
| Entity Type | Organization |
| Organization Name | THE DERMATOLOGY CENTER OF CONNECTICUT, LLC |
| Practice Address |
60 Church St Unit 4b Wallingford CT 06492-2340 |
| Mailing Address |
1790 Cheshire St Cheshire CT 06410-1237 |
| Practice Telephone | 2039078474 |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |
| Authorized Official Name | KIMBERLY ELLEN BOLDON (OWNER) |
| Authorized Official Telephone | 2039078474 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
60 CHURCH ST UNIT 4B |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-2340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| 1528692480 | Hilary Caitlin Sullivan | Nurse Practitioner | Park Avenue Medical, LLC, 85 Barnes Road, Suite 202, Wallingford, CT 06492 | 2020-02-28 |
| 1902370943 | Alicia Anne Eldridge | Student in an Organized Health Care Education/Training Program | 88 Cheshire Road, Wallingford, CT 06492 | 2019-01-13 |
| 1114409562 | Doreen Gail Barile | Pharmacist | 846 North Colony Road, Wallingford, CT 06492 | 2018-09-02 |
| 1942782354 | Brad Becker | Pharmacist | 846 North Colony Rd, Walingford, CT 06492 | 2018-08-31 |
| 1477041564 | Melissa A Fazzolari | Nurse Practitioner | 850 N Main Street Ext Ste B, Wallingford, CT 06492 | 2018-04-25 |
| 1992235857 | Karen Ann Meers | Behavioral Analyst | 29 North Plains Highway, Unit 15, Wallingford, CT 06492 | 2017-06-14 |
| 1992232698 | Chelsea Clements | Occupational Therapist | 87 Southwind Dr, Wallingford, CT 06492 | 2017-05-12 |
| 1659822369 | Sara Frawley | Naturopath | 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 | 2016-10-18 |
| 1083085518 | Energetic Spine Chiropractic | Chiropractor | 1271 South Broad St., Unit #11, Wallingford, CT 06492 | 2015-10-09 |
| Find all providers in zip 06492 | ||||
| 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 |
|---|---|---|---|---|
| 1477175966 | Young Skin | Dermatology | 1111 Summer St, Stamford, CT 06905-5508 | 2020-05-07 |
| 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 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| Find all providers with the same taxonomy | ||||
| City | WALLINGFORD |
| Zip Code | 06492 |
Please comment or provide details below to improve the information on THE DERMATOLOGY CENTER OF CONNECTICUT, LLC.
| 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.