EASTERN CONNECTICUT DERMATOLOGY
NPI 1265868558
Dermatology in Groton, CT

Active since September 19, 2013CLIA 07D0095280 · Microscopy
481 GOLD STAR HWY STE 201, GROTON, CT 06340(860) 445-8020 Get Directions Write a Review

NPPES record last updated: January 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eastern Connecticut Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTERN CONNECTICUT DERMATOLOGY (NPI 1265868558) is a healthcare organization registered as a dermatology in Groton, Connecticut and active in the NPI registry since September 2013. The organization holds a CLIA Microscopy certificate valid through February 9, 2028 and lists Jeffrey D. Queen, Manager, as its authorized official.

NPPES Registry Identity

NPI1265868558
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF GROTON LLC
Location Address481 GOLD STAR HWY STE 201Groton, CT 06340-6702
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Organization SubpartNo
Authorized OfficialJeffrey D. QueenManager · (561) 314-2000
Enumeration DateSeptember 19, 2013
Last NPPES UpdateJanuary 11, 2019
NPI 1265868558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
481 GOLD STAR HWY STE 201, Groton, CT 06340

Other Names 1

Doing Business AsEastern Connecticut Dermatology

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 07D0095280

Integrated Dermatology Of Groton · Groton, CT
Active · expires Feb 9, 2028
CLIA Number07D0095280
Laboratory TypePhysician Office
Certificate Effective DateFebruary 10, 2026
Certificate Expiration DateFebruary 9, 2028
Laboratory DirectorRobert B. Ecker
Laboratory Phone(860) 445-8020
Laboratory LocationIntegrated Dermatology Of Groton481 Gold Star Hwy, Ste 201, Groton, CT 06340
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
481 GOLD STAR HWY STE 201
GROTON, CT 06340

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Integrated Dermatology Of Groton LLC's NPI number?

The NPI number for Integrated Dermatology Of Groton LLC is 1265868558. It was assigned to this organization in the NPPES registry on September 19, 2013. The provider is doing business as Eastern Connecticut Dermatology.

Where is Integrated Dermatology Of Groton LLC located?

Integrated Dermatology Of Groton LLC is located at 481 Gold Star Hwy Ste 201, Groton, CT 06340. The listed phone number is (860) 445-8020.

What is Integrated Dermatology Of Groton LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Integrated Dermatology Of Groton LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 07D0095280) is associated with this NPI, valid through February 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Integrated Dermatology Of Groton LLC was last updated on January 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.