Organization
DERMATOLOGY CENTER OF STAMFORD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA PRUZAN-CLAIN M.D. (PHYSICIAN/PRESIDENT)
(203) 325-3576
Entity
Organization
Contact information
Practice address
1290 SUMMER ST, SUITE 3600, STAMFORD, CT 06905-5360
(203) 325-3576
(203) 325-4280
Mailing address
1290 SUMMER ST, SUITE 3600, STAMFORD, CT 06905-5360
(203) 325-3576
(203) 325-4280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF8653
RAILROAD MEDICARE
CT
Enumeration date
08/15/2005
Last updated
03/13/2015
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