Center for Skin Surgery & Dermatology, PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

040694 Issued in CT

Legal business name

CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC

Practice address

2928 Main St Ste 100
Glastonbury, CT 06033-1007

Phone

(860) 633-2332

Fax

(860) 633-2352

NPI assigned

Aug 30, 2017

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine Giglio

Title

Practice Manager

Phone

(860) 676-1900

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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.

• Siobhan Collins, MD

  • MOHS-Micrographic Surgery Physician
  • Farmington, CT
  • NPI 1790888584

  Dermatology

  Medicare reassignment NPD
• Omar A Ibrahimi, MD, PHD

  • MOHS-Micrographic Surgery Physician
  • Stamford, CT
  • NPI 1508061128

  Dermatology

  NPD

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1407374481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 MAIN ST STE 100",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331007",
            "telephone_number": "860-633-2332",
            "fax_number": "860-633-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 MAIN ST STE 100",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331007",
            "telephone_number": "860-633-2332",
            "fax_number": "860-633-2352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "499 Farmington Ave Ste 230",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060321933",
            "country_code": "US",
            "telephone_number": "860-676-1900",
            "fax_number": "860-409-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR SKIN SURGERY & DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GIGLIO",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "860-676-1900"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CT",
            "license": "040694",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CT",
            "license": "040694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "040694",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790888584",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Susanne Cesana, HEALTH COACH
• Jenny Y Cha, O.D.

• MOHS-Micrographic Surgery Physician in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• MOHS-Micrographic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.