Organization
FAIRFIELD DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVAN S. COHEN M.D. (PRESIDENT)
(203) 259-7709
Entity
Organization
Contact information
Practice address
1305 POST RD, 310, FAIRFIELD, CT 06824-6016
(203) 259-7709
(203) 255-3585
Mailing address
1305 POST RD, 310, FAIRFIELD, CT 06824-6016
(203) 259-7709
(203) 255-3585
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14371
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02974
MEDICARE GROUP
CT
Enumeration date
01/28/2008
Last updated
10/03/2018
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