NPI 1992890362 · live from the CMS NPI Registry
Coastal Dermatology, P.C.
Dermatology in Mystic, CT. National Provider Identifier 1992890362, active.
NPI record
| NPI | 1992890362 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 55 Willow Street, Mystic, CT 06355 |
| Practice phone | 860-245-0000 |
| Enumerated | October 3, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Daniella Duke, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | 035895 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.