Integrated Dermatology of Groton LLC
NPI 1265868558ActiveOrganization· Dermatology· Groton, CT
Dermatology in Groton, Connecticut, registered in NPPES in September 2013. The authorized official on file is Jeffrey D. Queen, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1265868558 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 19, 2013 |
| Last updated in NPPES | Jan 11, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CT) |
|---|
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