Dermatology Physicians of Connecticut PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

040226 Issued in CT

Legal business name

DERMATOLOGY PHYSICIANS OF CONNECTICUT PC

Practice address

4 Corporate Dr
Ste 386
Shelton, CT 06484-6211

Phone

(203) 856-6373

Fax

(203) 957-3536

NPI assigned

Jan 28, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Loyd S Godwin, MD

Title

President

Phone

(203) 856-6373

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1942548847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR",
            "address_2": "STE 386",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846211",
            "telephone_number": "203-856-6373",
            "fax_number": "203-957-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR",
            "address_2": "STE 386",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846211",
            "telephone_number": "203-856-6373",
            "fax_number": "203-957-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY PHYSICIANS OF CONNECTICUT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "GODWIN",
        "authorized_official_first_name": "LOYD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-856-6373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "040226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Demayo, NCC, LMHC, LPC
• Taylor Rose Denardo
• Dental Associates of Shelton, LLP
• David Depetris, BCBA, LBA, LABA
• Lauren Depetris, BCBA
• Bijal Desai, O.D.
• Marilyn Deshan
• Rafael Desousa, DC
• Edward A Dessau, D.C.
• Gregory S Destefano, APRN

• Specialist in Shelton, CT
• Providers in Shelton, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.