EASTERN CONNECTICUT DERMATOLOGY
NPI 1265868558
Dermatology in Groton, CT
NPI Status: Active since September 19, 2013
Contact Information
481 GOLD STAR HWY STE 201
GROTON, CT
ZIP 06340
Phone: (860) 445-8020
- Organization
- Dermatology
- CLIA Number: 07D0095280
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-05-2026
About EASTERN CONNECTICUT DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Eastern Connecticut Dermatology, a provider established in Groton, Connecticut operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1265868558 assigned on September 2013. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Eastern Connecticut Dermatology. The authorized official of this NPI record is Jeffrey D. Queen (Manager)
- NPI
- 1265868558
- Provider Legal Name
- INTEGRATED DERMATOLOGY OF GROTON LLC
- Other Organization Name
- EASTERN CONNECTICUT DERMATOLOGY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 481 GOLD STAR HWY STE 201 GROTON, CT 06340
- Location Phone
- (860) 445-8020
- Mailing Address
- 4700 EXCHANGE CT STE 110 BOCA RATON, FL 33431
- Mailing Phone
- (561) 314-2000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-19-2013
- Last Update Date
- 01-11-2019
- Code Navigator
A dermatologist like Eastern Connecticut Dermatology is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D0095280
- Facility Type
- Physician Office
- Certificate Effective Date
- April 06, 2024
- Certificate Expiration Date
- April 05, 2026
- Laboratory Director
- ROBERT B. ECKER
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Eastern Connecticut Dermatology after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 6 | 5 | 8 | 6 | 8 | 5 | 5 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 12 | 5 | 16 | 6 | 16 | 5 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 2 + 5 + 1 + 6 + 6 + 1 + 6 + 5 + 1 + 0 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1265868558 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265868558, enumerated in the NPI registry as an "organization" on September 19, 2013
The provider is located at 481 Gold Star Hwy Ste 201 Groton, Ct 06340 and the phone number is (860) 445-8020
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider's CLIA number is 07D0095280 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on September 19, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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