Organization
CONNECTICUT ASTHMA & ALLERGY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL P GRODOFSKY MD (PHYSICIAN MEMBER)
(860) 232-9911
Entity
Organization
Contact information
Practice address
836 FARMINGTON AVE, SUITE 207, WEST HARTFORD, CT 06119
(860) 232-9911
(860) 233-5996
Mailing address
836 FARMINGTON AVE, SUITE 207, WEST HARTFORD, CT 06119
(860) 232-9911
(860) 233-5996
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043518
AETNA
—
Enumeration date
03/24/2006
Last updated
09/28/2011
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