NPI 1164835153

Farmington Valley Dermatology and Surgery, LLC

Organisation Dermatology Physician Avon, CT

Practice location

Address: 30 W Avon Rd STE E, Avon, CT 06001-3678
Phone: (860) 674-9900
Fax: (860) 678-0036

Authorised official

Name: Sadaf Waqar
Title: Owner
Phone: (860) 674-9900

Registered specialties (2)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 53002 (CT)

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Non-Pharmacy Dispensing Site

Suppliers Taxonomy 332900000X

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Registry record

NPI: 1164835153
Entity type: Organization
NPI issued: 6 Jun 2014
Record last updated: 14 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.