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MODERN DERMATOLOGY PC
NPI 1497258719
Dermatology in Westport, CT

Active since March 13, 2018CLIA Certified · 2 labs
1032 POST RD E, WESTPORT, CT 06880(203) 635-0770(203) 635-0771 Get Directions Write a Review

NPPES record last updated: July 18, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 18, 2018, Mar 13, 2018 (2 updates tracked since 2018).

About Modern Dermatology Pc NPPES

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

MODERN DERMATOLOGY PC (NPI 1497258719) is a healthcare organization registered as a dermatology in Westport, Connecticut and active in the NPI registry since March 2018. The organization holds 2 active CLIA laboratory certificates and lists Ina King, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1497258719
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMODERN DERMATOLOGY PC
Location Address1032 POST RD EWestport, CT 06880
Mailing Address1032 Post Rd EWestport, CT 06880-5369 · (203) 635-0770 · Fax (203) 635-0771
Phone(203) 635-0770
Fax(203) 635-0771
Organization SubpartNo
Authorized OfficialIna KingOffice Manager · (201) 294-5841
Enumeration DateMarch 13, 2018
Last NPPES UpdateJuly 18, 20182 updates tracked since enumeration
✔ NPI 1497258719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CT · 049946
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.
1032 POST RD E, Westport, CT 06880
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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 2

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 of Compliance 07D2205250

Modern Dermatology PC · Westport, CT
Active · expires Jan 11, 2028
CLIA Number07D2205250
Laboratory TypePhysician Office
Certificate Effective DateJanuary 12, 2026
Certificate Expiration DateJanuary 11, 2028
Laboratory DirectorShayan Cheraghlou
Laboratory Phone(203) 635-0770
Laboratory LocationModern Dermatology PC1032 Post Rd East, Westport, CT 06880
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 07D2343513

Modern Dermatology-Greenwich Lab · Greenwich, CT
Active · expires May 6, 2028
CLIA Number07D2343513
Laboratory TypePhysician Office
Certificate Effective DateMay 7, 2026
Certificate Expiration DateMay 6, 2028
Laboratory DirectorMichael K. Miller
Laboratory Phone(203) 635-0770
Laboratory LocationModern Dermatology-Greenwich Lab75 Holly Hill Ln, Ste 301, Greenwich, CT 06830
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

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

NINA KATHERINE ANTONOV M.D.
Dermatology
1032 POST RD E
WESTPORT, CT 06880
Western Connecticut Planning Region (203) 635-0770
MELANIE CONLY
Physical Therapist
1032 POST RD E
WESTPORT, CT 06880
Western Connecticut Planning Region (203) 635-0770

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 Modern Dermatology PC's NPI number?

The NPI number for Modern Dermatology PC is 1497258719. It was assigned to this organization in the NPPES registry on March 13, 2018.

Where is Modern Dermatology PC located?

Modern Dermatology PC is located at 1032 Post Rd E, Westport, CT 06880. The listed phone number is (203) 635-0770.

What is Modern Dermatology PC's specialty?

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

Does Modern Dermatology PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Modern Dermatology PC was last updated on July 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.