Advanced Dermatology Center, PC

Organization Active NPI Dermatology Physician · Wolcott, CT

NPI 1639160294 · NPPES record last updated Aug 17, 2026

Key facts

NPI
1639160294
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
License
035267 (CT)
Legal business name
ADVANCED DERMATOLOGY CENTER, PC
Practice address
464 Wolcott Rd
Wolcott, CT 06716-2626
Phone
(203) 879-6171
Fax
(203) 879-1191
NPI assigned
Nov 2, 2005
Organization subpart
No

Authorized official

Name
Ronald S. Jurzyk, MD NPI 1215910922
Title
Owner
Phone
(203) 879-6171

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040304000894 CT Part B Supplier - Clinic/Group Practice 5294623005 Receives reassigned benefits from 4 practitioners
Practice locations: Wolcott, CT

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207N00000X 035267 CT Yes

Addresses

Primary practice location

464 Wolcott Rd
Wolcott, CT 06716-2626

Mailing address

464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171

Other identifiers

IdentifierTypeStateIssuer
DB0248OtherCTRAILROAD MEDICARE

Other names

  • Advanced Dermatology Center, PC Doing business as
  • Ronald Jurzyk MD Doing business as

Other providers in Wolcott, CT

All providers in Wolcott, CT · Dermatology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.