| NPI | 1992563902 |
|---|---|
| Former Legal Business Name | FARMINGTON VALLEY DERMATOLOGY &SURGERY |
| Former Legal Business Name | FVDS |
| Entity Type | Organization |
| Authorized Contact | SADAF WAQAR Owner/Provider 860-674-9900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |