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General NPI Number Information
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NPI Number | 1134319205
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Entity Type | Organization
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Legal Business Name | CHESHIRE DERMATOLOGY PLLC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 677 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3158
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Country | US
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Telephone | 203-250-7577
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Fax | 203-250-0739
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Provider Business Mailing Address
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Address Line | 677 S MAIN ST
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City | CHESHIRE
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State | CT
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Zip | 06410-3158
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Country | US
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Telephone | 203-250-7577
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Fax | 203-250-0739
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANA MARIE CORREALE
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Credential | M.D.
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Telephone | 203-250-7577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 029901
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License Number State | CT
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