Provider Demographics
NPI:1912446782
Name:ASSOCIATES IN MEDICAL & COSMETIC DERMATOLOGY, PC
Entity Type:Organization
Organization Name:ASSOCIATES IN MEDICAL & COSMETIC DERMATOLOGY, PC
Other - Org Name:DOUGLAS L. BILINSKI, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:BILINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-281-6678
Mailing Address - Street 1:9 WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-281-6678
Mailing Address - Fax:203-281-3190
Practice Address - Street 1:9 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518
Practice Address - Country:US
Practice Address - Phone:203-281-6678
Practice Address - Fax:203-281-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026627207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT070000371Medicare UPIN