Organization Name: | ALLERGY ASSOCIATES OF HARTFORD, PC |
NPI Number: | 1003937988 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PRASAD SRINIVASAN (PRESIDENT) |
Mailing Address: | 19 Woodland St Suite 11 Hartford |
State: | CT US |
Postal Code: | 061052372 |
Phone Number: | 8602467273 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 05/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 000644 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |