Provider Demographics
NPI:1962933572
Name:KLUFAS, DANIEL MARK
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:MARK
Last Name:KLUFAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8082
Mailing Address - Country:US
Mailing Address - Phone:860-679-4600
Mailing Address - Fax:860-679-1248
Practice Address - Street 1:21 SOUTH RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2482
Practice Address - Country:US
Practice Address - Phone:860-679-4600
Practice Address - Fax:860-679-1248
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT082718207ND0101X
390200000X
CAA161515207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207N00000XAllopathic & Osteopathic PhysiciansDermatology