ADVANCED DERMCARE PC NPI 1023068087

NPI Information

  • NPI: 1023068087
  • Provider Name: ADVANCED DERMCARE PC
  • Classification: Dermatology - 207N00000X
  • Entity Type: Organization
  • CLIA Number: 07D0100947
  • Address: 25 TAMARACK AVE
    ADVANCED DERM CARE PC
    DANBURY, CT
    ZIP 06811
  • Phone: (203) 797-8990

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NPI Details

ADVANCED DERMCARE PC is a dermatology in Danbury, CT. The provider is 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. ADVANCED DERMCARE PC NPI is 1023068087. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

25 TAMARACK AVE
ADVANCED DERM CARE PC
DANBURY, CT
ZIP 06811
Phone: (203) 797-8990
Fax: (203) 748-7861

The provider's authorized official is Diane Edmond .
The authorized official title is Credentialing and has the following contact phone number (203) 731-2207.

The CLIA number assigned to this NPI record is 07D0100947 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/11/2006 and was last updated on 3/6/2024.

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
1207N00000XDermatologyYes

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
1004395390MEDICAIDCONNECTICUT

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: 11/21/2025

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