Organization
INTEGRATED DERMATOLOGY OF GROTON LLC
Active
Other names
Eastern Connecticut Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D. QUEEN (MANAGER)
(561) 314-2000
Entity
Organization
Contact information
Practice address
481 GOLD STAR HWY STE 201, GROTON, CT 06340-6702
(860) 445-8020
Mailing address
4700 EXCHANGE CT STE 110, BOCA RATON, FL 33431-4450
(561) 314-2000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
09/19/2013
Last updated
01/11/2019
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