Individual
DR. JERILYN S ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
36 WATSON ST, WILLIMANTIC, CT 06226-2122
(860) 456-0287
(860) 456-3532
Mailing address
36 WATSON ST, WILLIMANTIC, CT 06226-2122
(860) 456-0287
(860) 456-3532
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
034032
CT
207YS0123X
Facial Plastic Surgery Physician
034032
CT
207YX0602X
Otolaryngic Allergy Physician
034032
CT
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
034032
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001340322
—
CT
Enumeration date
06/23/2006
Last updated
02/22/2018
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