Organization
ALLERGY AND ASTHMA CARE OF FAIRFIELD COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH S. BACKMAN M.D. (PRESIDENT)
(203) 259-7070
Entity
Organization
Contact information
Practice address
55 WALLS DR, STE 405, FAIRFIELD, CT 06824-5163
(203) 259-7070
(203) 254-7402
Mailing address
55 WALLS DR, SUITE 405, FAIRFIELD, CT 06824-5163
(203) 259-7070
(203) 254-7402
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
038854
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010038854CT02
ANTHEM
CT
01
—
038854
CONNECTICARE
CT
01
—
0V8243
HEALTHNET
CT
01
—
1439465
UNITED HEALTHCARE
CT
01
—
7914842006
CIGNA
CT
01
—
P861731
OXFORD
CT
Enumeration date
08/31/2006
Last updated
09/06/2007
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