NPI 1336872233 · live from the CMS NPI Registry
Integrated Dermatology Of Glastonbury PLLC
Dermatology in Glastonbury, CT. National Provider Identifier 1336872233, active.
NPI record
| NPI | 1336872233 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 622 Hebron Ave Ste 107, Glastonbury, CT 06033 |
| Practice phone | 860-657-3376 |
| Mailing address | 4700 Exchange Ct Ste 110, Boca Raton, FL 33431 |
| Enumerated | July 7, 2022 |
| Last updated | July 7, 2022 |
| Authorized official | Animesh Sinha, Authorized Group Official |
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.