NPI 1063433969 · live from the CMS NPI Registry
Advanced Dermatology & Laser Center, LLC
Dermatology in Westport, CT. National Provider Identifier 1063433969, active.
NPI record
| NPI | 1063433969 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 489 Post Road East, Westport, CT 06880 |
| Practice phone | 203-226-3600 |
| Enumerated | July 23, 2006 |
| Last updated | February 6, 2013 |
| Authorized official | Tanya Futoryan, Medical Director |
| Other names | Westport Dermatology |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | 035123 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.