Provider Demographics
NPI:1427430230
Name:GREENWICH POINT DERMATOLOGY LLC
Entity type:Organization
Organization Name:GREENWICH POINT DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-764-2230
Mailing Address - Street 1:20 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6529
Mailing Address - Country:US
Mailing Address - Phone:203-764-2230
Mailing Address - Fax:203-666-8946
Practice Address - Street 1:20 E ELM ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6529
Practice Address - Country:US
Practice Address - Phone:203-764-2230
Practice Address - Fax:203-666-8946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty