Provider Demographics
NPI:1407903214
Name:POCIASK, CELESTE (MD)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:POCIASK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:
Other - Last Name:ROMIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:17 OLD KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4522
Mailing Address - Country:US
Mailing Address - Phone:203-655-1151
Mailing Address - Fax:
Practice Address - Street 1:17 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4522
Practice Address - Country:US
Practice Address - Phone:203-655-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT022765207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D02831Medicare UPIN