NPI 1457649063 · live from the CMS NPI Registry
Tyler Durazzo, M.D.
Dermatology in New Haven, CT. National Provider Identifier 1457649063, active.
NPI record
| NPI | 1457649063 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 1450 Chapel St, New Haven, CT 06511 |
| Practice phone | 203-789-3034 |
| Mailing address | 4 Corporate Drive, Suite 386, Shelton, CT 06484 |
| Enumerated | July 17, 2011 |
| Last updated | November 25, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | 54442 (CT) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.