NPI 1134544661 · live from the CMS NPI Registry
Integrated Dermatology Of Enfield, LLC
Dermatology in Simsbury, CT. National Provider Identifier 1134544661, active.
NPI record
| NPI | 1134544661 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 714 Hopmeadow St Ste 5, Simsbury, CT 06070 |
| Practice phone | 860-741-2225 |
| Mailing address | 4700 Exchange Ct Ste 110, Boca Raton, FL 33431 |
| Enumerated | February 20, 2014 |
| Last updated | June 11, 2025 |
| Authorized official | Jeffrey Queen, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | — |
| Physician Assistant | 363A00000X | — |
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.