Healthcare Provider Details

I. General information

NPI: 1871938381
Provider Name (Legal Business Name): WILLIAM DAMSKY M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 COLUMBUS AVE
NEW HAVEN CT
06519-1233
US

IV. Provider business mailing address

333 CEDAR ST # ST501 PO BOX 208059
NEW HAVEN CT
06510-3206
US

V. Phone/Fax

Practice location:
  • Phone: 203-503-3000
  • Fax:
Mailing address:
  • Phone: 203-785-4092
  • Fax: 203-785-7637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number56081
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: