Organization Active NPI

Integrated Dermatology of Middletown, PLLC

  • Dermatology Physician
  • Middletown, CT
National Provider Identifier
1285379529
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
INTEGRATED DERMATOLOGY OF MIDDLETOWN, PLLC
Practice address
11 S Main St
Middletown, CT 06457-3656
Phone
(860) 347-4555
NPI assigned
May 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Animesh Sinha, MD
Title
Authorized Group Official
Phone
(561) 314-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

11 S Main St
Middletown, CT 06457-3656

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1285379529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573656",
            "telephone_number": "860-347-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DERMATOLOGY OF MIDDLETOWN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "SINHA",
        "authorized_official_first_name": "ANIMESH",
        "authorized_official_title_or_position": "AUTHORIZED GROUP OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.