NPI 1003644402 · live from the CMS NPI Registry
Elite Dermatology Physicians PLLC
Dermatology in New Canaan, CT. National Provider Identifier 1003644402, active.
NPI record
| NPI | 1003644402 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 38 East Ave, New Canaan, CT 06840 |
| Practice phone | 415-802-1310 |
| Enumerated | July 25, 2024 |
| Last updated | July 25, 2024 |
| Authorized official | Ellen De Moll, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.