Organization
TDG CONNECTICUT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON SAMAHA MD (CEO)
(973) 571-2121
Entity
Organization
Contact information
Practice address
134 PARK ST, NEW HAVEN, CT 06511-5409
(973) 571-2121
(973) 498-0512
Mailing address
347 MOUNT PLEASANT AVE STE 205, WEST ORANGE, NJ 07052-2749
(973) 571-2121
(973) 498-0512
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/20/2017
Last updated
11/30/2017
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