Organization
COASTAL DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLA DUKE M.D. (PRESIDENT)
(860) 245-0000
Entity
Organization
Contact information
Practice address
55 WILLOW STREET, MYSTIC, CT 06355
(860) 245-0000
(860) 245-0610
Mailing address
55 WILLOW STREET, MYSTIC, CT 06355
(860) 245-0000
(860) 245-0610
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
035895
CT
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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