Organization
CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE GIGLIO (PRACTICE MANAGER)
(860) 676-1900
Entity
Organization
Contact information
Practice address
2928 MAIN ST STE 100, GLASTONBURY, CT 06033-1007
(860) 633-2332
(860) 633-2352
Mailing address
2928 MAIN ST STE 100, GLASTONBURY, CT 06033-1007
(860) 633-2332
(860) 633-2352
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
040694
CT
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
040694
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040694
MEDICAL LICENSE
CT
01
—
1790888584
NPI
—
Enumeration date
08/30/2017
Last updated
03/07/2023
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