Daniella Duke, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

035895 Issued in CT

Practice address

55 Willow St
Mystic, CT 06355-2636

Phone

(860) 245-0000

Fax

(860) 245-0610

NPI assigned

Jan 28, 2006

Last updated

Apr 28, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Dermatology, P.C.

  • Dermatology Physician
  • Mystic, CT
  • NPI 1992890362
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1174594279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WILLOW ST",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552636",
            "telephone_number": "860-245-0000",
            "fax_number": "860-245-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WILLOW ST",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552636",
            "telephone_number": "860-245-0000",
            "fax_number": "860-245-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "DANIELLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "035895",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "MD10187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Doucette, APRN
• Dr. Sally Vail & Dr. Linda Robson, PC
• Stephanie Jo Draus, ND
• Kathleen D. Dreher
• James D. Duffy, MD
• Ease Counseling LLC
• Madlene Eskarose
• Fair Winds Counseling, LLC
• Falck Eye Center LLC
• Falck Eye Centers, L.L.C.

• Dermatology Physician in Mystic, CT
• Providers in Mystic, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.