Organization
SKIN DOCS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS MAZZELLA MD (SOLE MEMBER)
(404) 805-2290
Entity
Organization
Contact information
Practice address
2321 BLACK ROCK TPKE, HALL 2, FAIRFIELD, CT 06825-3220
(404) 805-2290
(203) 372-0506
Mailing address
2321 BLACK ROCK TPKE, HALL 2, FAIRFIELD, CT 06825-3220
(404) 805-2290
(203) 372-0506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CT
208600000X
Surgery Physician
—
CT
Other
Enumeration date
07/30/2012
Last updated
09/19/2014
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