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Organization

ALLERGY ASSOCIATES OF HARTFORD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PRASAD SRINIVASAN (PRESIDENT)
(860) 246-7273
Entity
Organization

Contact information

Practice address
622 HEBRON AVE STE 104B, GLASTONBURY, CT 06033-5003
(860) 659-8904
(860) 246-5828
Mailing address
622 HEBRON AVE STE 104B, GLASTONBURY, CT 06033-5003
(860) 659-8904
(860) 246-5828

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
022206
CT
363AM0700X
Medical Physician Assistant
000644
CT
363LF0000X
Family Nurse Practitioner
003860
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004000410
CT
Enumeration date
04/02/2007
Last updated
11/12/2024
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