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INTEGRATED DERMATOLOGY OF BRIDGEPORT, PLLC
NPI 1952897704
Dermatology in Bridgeport, CT

Active since July 05, 2018CLIA 07D2026577 · Certificate of Compliance
4639 MAIN ST, BRIDGEPORT, CT 06606(203) 374-5546(203) 371-4056 Get Directions Write a Review

NPPES record last updated: January 15, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 15, 2019, Jul 5, 2018 (2 updates tracked since 2018).

About Integrated Dermatology Of Bridgeport, Pllc NPPES

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

INTEGRATED DERMATOLOGY OF BRIDGEPORT, PLLC (NPI 1952897704) is a healthcare organization registered as a dermatology in Bridgeport, Connecticut and active in the NPI registry since July 2018. The organization holds a CLIA Certificate of Compliance certificate valid through October 20, 2026 and lists Adam S. Plotkin, Authorized Group Official, as its authorized official.

NPPES Registry Identity

NPI1952897704
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF BRIDGEPORT, PLLC
Location Address4639 MAIN STBridgeport, CT 06606-1832
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000 · Fax (561) 431-2821
Phone(203) 374-5546
Fax(203) 371-4056
Organization SubpartNo
Authorized OfficialAdam S. PlotkinAuthorized Group Official · (561) 314-2000
Enumeration DateJuly 5, 2018
Last NPPES UpdateJanuary 15, 20192 updates tracked since enumeration
✔ NPI 1952897704 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.
4639 MAIN ST, Bridgeport, CT 06606
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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

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 07D2026577

Integrated Dermatology Of Bridgeport · Trumbull, CT
Active · expires Oct 20, 2026
CLIA Number07D2026577
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2024
Certificate Expiration DateOctober 20, 2026
Laboratory DirectorAndrew Kelsey
Laboratory Phone(203) 374-5546
Laboratory LocationIntegrated Dermatology Of Bridgeport7 Cambridge D, 2nd Flr, Trumbull, CT 06611
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 4

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

MOSS AND MAIOCCO MD LLC
Dermatology
4639 MAIN ST
BRIDGEPORT, CT 06606
Greater Bridgeport Planning Region (203) 374-5546
ARCADIA HEALTH SERVICES, INC.
Home Health
4639 MAIN ST, SUITE 6
BRIDGEPORT, CT 06606
Greater Bridgeport Planning Region (203) 378-2478
DR. KENNETH JOSEPH MAIOCCO M.D.
Dermatology
4639 MAIN ST
BRIDGEPORT, CT 06606
Greater Bridgeport Planning Region (203) 374-5546
KENNETH J. MAIOCCO, M.D., P.C.
Dermatology
4639 MAIN ST
BRIDGEPORT, CT 06606
Greater Bridgeport Planning Region (203) 374-5546

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 Bridgeport, PLLC's NPI number?

The NPI number for Integrated Dermatology Of Bridgeport, PLLC is 1952897704. It was assigned to this organization in the NPPES registry on July 5, 2018.

Where is Integrated Dermatology Of Bridgeport, PLLC located?

Integrated Dermatology Of Bridgeport, PLLC is located at 4639 Main St, Bridgeport, CT 06606. The listed phone number is (203) 374-5546.

What is Integrated Dermatology Of Bridgeport, PLLC's specialty?

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

Does Integrated Dermatology Of Bridgeport, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 07D2026577) is associated with this NPI, valid through October 20, 2026. 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 Bridgeport, PLLC was last updated on January 15, 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.