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CENTER FOR SKIN SURGERY & DERMATOLOGY PLLC NPI 1407374481


NPI Information

NPI: 1407374481
Provider Name: CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 07D2032064

Address:
2928 MAIN ST STE 100
GLASTONBURY, CT
ZIP 06033
Phone: (860) 633-2332
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CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC is a mohs-micrographic surgery dermatology in Glastonbury, CT. The provider is 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. CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC NPI is 1407374481. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2928 MAIN ST STE 100
GLASTONBURY, CT
ZIP 06033-007
Phone: (860) 633-2332
Fax: (860) 633-2352

The provider's authorized official is Christine Giglio .
The authorized official title is Practice Manager and has the following contact phone number (860) 676-1900.

The CLIA number assigned to this NPI record is 07D2032064 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/30/2017 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatology040694CONNECTICUTNo
2207ND0101XDermatologyMOHS-Micrographic Surgery040694CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1040694OTHERCONNECTICUTMEDICAL LICENSE
21790888584OTHERNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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