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JOHN W. EDELGLASS M.D. P.C. NPI 1710187505


NPI Information

NPI: 1710187505
Provider Name: JOHN W. EDELGLASS M.D., P.C.
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
1 BRADLEY RD
SUITE 705
WOODBRIDGE, CT
ZIP 06525
Phone: (203) 389-1185
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JOHN W. EDELGLASS M.D., P.C. is a procedural dermatology dermatology in Woodbridge, CT. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). JOHN W. EDELGLASS M.D., P.C. NPI is 1710187505. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1 BRADLEY RD
SUITE 705
WOODBRIDGE, CT
ZIP 06525-285
Phone: (203) 389-1185
Fax: (203) 389-1427

The provider's authorized official is John Warren Edelglass .
The authorized official title is President and has the following contact phone number (203) 389-1185.

The enumeration date for this NPI number is 7/20/2007 and was last updated on 8/12/2007.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural Dermatology023280CONNECTICUTYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C00153OTHERCONNECTICUTMEDICARE GROUP

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: 5/5/2024

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