| NPI | 1639377690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JEFFREY GOLDSTEIN President/Physician 203-787-4171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 025369) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-09-08 |