Active NPI
Central Connecticut Dermatology, PLLC
- Dermatology Physician
- Cromwell, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- CENTRAL CONNECTICUT DERMATOLOGY, PLLC
- Practice address
- 1 Willowbrook Rd Ste 2
Cromwell, CT 06416-1745 - Phone
- (860) 322-2222
- Fax
- (860) 322-6838
- NPI assigned
- Feb 21, 2019
- Last updated
- Jul 26, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bruce E Strober, MD
- Title
- Provider
- Phone
- (860) 322-2222
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
1 Willowbrook Rd Ste 2
Cromwell, CT 06416-1745
Mailing address
1 Willowbrook Rd Ste 2
Cromwell, CT 06416-1745
Phone (860) 322-2222
Other practice location 1
30 Knotter Drive
Southington, CT 06489
Phone (860) 400-2000
Other practice location 2
40 Dale Rd Ste 100
Avon, CT 06001-3692
Phone (860) 322-2222
Other practice location 3
499 Farmington Ave Ste 230
Farmington, CT 06032-1933
Phone (860) 322-2222
Other practice location 4
1 Northwestern Dr Ste 301
Bloomfield, CT 06002-3400
Phone (860) 322-2222
Other practice location 5
340 Buckland Rd Fl 2
South Windsor, CT 06074-3725
Phone (860) 322-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D1033034 | Central Connecticut Dermatology | Compliance | Apr 28, 2027 |
| 07D2167375 | Central Connecticut Dermatology | Compliance | May 23, 2027 |
| 07D2167761 | Central Connecticut Dermatology | Compliance | Jun 7, 2027 |
| 07D2186465 | Central Connecticut Dermatology | Provider-performed microscopy | Jun 16, 2028 |
| 07D2210603 | Central Connecticut Dermatology Bloomfield | Compliance | Sep 26, 2027 |
| 07D2284346 | Central Connecticut Dermatology | Provider-performed microscopy | Jun 20, 2027 |
National Provider Directory
National Provider DirectoryLocations
40 Dale Rd
Ste 100
Avon, CT 06001
Phone (860) 322-2222
30 Knotter Dr
Ste 2
Cheshire, CT 06410
499 Farmington Ave
Ste 230
Farmington, CT 06032
Phone (860) 322-2222
340 Buckland Rd
South Windsor, CT 06074
Phone (860) 322-2222
340 Buckland Rd
Fl 2
South Windsor, CT 06074
Phone (860) 322-2222
Practitioners & affiliated clinicians
Practitioners 22
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Dermatology Physician
- Cromwell, CT
- NPI 1619966652
-
- Dermatology Physician
- Cromwell, CT
- NPI 1164681573
-
- Dermatology Physician
- Cromwell, CT
- NPI 1841679503
-
- Family Nurse Practitioner
- South Windsor, CT
- NPI 1457100083
-
- Nurse Practitioner
- Cromwell, CT
- NPI 1891346334
-
- Dermatology Physician
- Cromwell, CT
- NPI 1437310869
-
- Physician Assistant
- Avon, CT
- NPI 1407690704
-
- Family Nurse Practitioner
- Rocky Hill, CT
- NPI 1386052710
-
- Dermatology Physician
- Cromwell, CT
- NPI 1861925356
-
- Dermatology Physician
- Cromwell, CT
- NPI 1134624000
-
- Physician Assistant
- Cromwell, CT
- NPI 1659262624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1690329600000",
"number": "1407313984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WILLOWBROOK RD STE 2",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064161745",
"telephone_number": "860-322-2222",
"fax_number": "860-322-6838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WILLOWBROOK RD STE 2",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064161745",
"telephone_number": "860-322-2222",
"fax_number": "860-322-6838"
}
],
"practiceLocations": [
{
"address_1": "30 Knotter Drive",
"address_purpose": "LOCATION",
"city": "Southington",
"state": "CT",
"postal_code": "06489",
"country_code": "US",
"telephone_number": "860-400-2000",
"fax_number": "860-400-3000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Dale Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Avon",
"state": "CT",
"postal_code": "060013692",
"country_code": "US",
"telephone_number": "860-322-2222",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "499 Farmington Ave Ste 230",
"address_purpose": "LOCATION",
"city": "Farmington",
"state": "CT",
"postal_code": "060321933",
"country_code": "US",
"telephone_number": "860-322-2222",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Northwestern Dr Ste 301",
"address_purpose": "LOCATION",
"city": "Bloomfield",
"state": "CT",
"postal_code": "060023400",
"country_code": "US",
"telephone_number": "860-322-2222",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "340 Buckland Rd Fl 2",
"address_purpose": "LOCATION",
"city": "South Windsor",
"state": "CT",
"postal_code": "060743725",
"country_code": "US",
"telephone_number": "860-322-2222",
"fax_number": "860-322-6838",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CENTRAL CONNECTICUT DERMATOLOGY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-21",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A",
"authorized_official_last_name": "STROBER",
"authorized_official_first_name": "BRUCE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "860-322-2222",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cromwell, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.