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CONNECTICUT ASTHMA & ALLERGY CENTER LLC NPI 1386604270


NPI Information

NPI: 1386604270
Provider Name: CONNECTICUT ASTHMA & ALLERGY CENTER LLC
Classification: Allergy & Immunology - 207KI0005X
Entity Type: Organization

Specialization: Clinical & Laboratory Immunology

CLIA Number: 07D0920641

Address:
836 FARMINGTON AVE
SUITE 207
WEST HARTFORD, CT
ZIP 06119
Phone: (860) 232-9911
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CONNECTICUT ASTHMA & ALLERGY CENTER LLC is a clinical and laboratory immunology allergy immunology in West Hartford, CT. The provider is an allergy and immunology physician who specializes in clinical and laboratory immunology disease management. Source: National Uniform Claim Committee, 2022 Additional Resources: A certification was, but is no longer, issued by the American Board of Allergy and Immunology. CONNECTICUT ASTHMA & ALLERGY CENTER LLC NPI is 1386604270. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

836 FARMINGTON AVE
SUITE 207
WEST HARTFORD, CT
ZIP 06119
Phone: (860) 232-9911
Fax: (860) 233-5996

The provider's authorized official is Marshall P Grodofsky .
The authorized official title is Physician Member and has the following contact phone number (860) 232-9911.

The CLIA number assigned to this NPI record is 07D0920641 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/24/2006 and was last updated on 9/28/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207KI0005XAllergy & ImmunologyClinical & Laboratory ImmunologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1043518OTHERAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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