NPI 1952897704 · live from the CMS NPI Registry
Integrated Dermatology Of Bridgeport, PLLC
Dermatology in Bridgeport, CT. National Provider Identifier 1952897704, active.
NPI record
| NPI | 1952897704 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 4639 Main St, Bridgeport, CT 06606 |
| Practice phone | 203-374-5546 |
| Mailing address | 4700 Exchange Ct Ste 110, Boca Raton, FL 33431 |
| Enumerated | July 5, 2018 |
| Last updated | January 15, 2019 |
| Authorized official | Adam Plotkin, 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.