Organization
MODERN DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INA KING (OFFICE MANAGER)
(201) 294-5841
Entity
Organization
Contact information
Practice address
1032 POST RD E, WESTPORT, CT 06880
(203) 635-0770
(203) 635-0771
Mailing address
1032 POST RD E, WESTPORT, CT 06880-5369
(203) 635-0770
(203) 635-0771
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
049946
CT
Other
Enumeration date
03/13/2018
Last updated
07/18/2018
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