Organization
CENTER FOR ALLERGY ASTHMA & IMMUNOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER CROIN RANDOLPH M.D. (CEO)
(203) 755-7080
Entity
Organization
Contact information
Practice address
1389 W MAIN ST, WATERBURY, CT 06708-3104
(203) 755-7080
(203) 597-5422
Mailing address
1389 W MAIN ST, SUITE 205, WATERBURY, CT 06708-3104
(203) 755-7080
(203) 597-5422
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
027063
CT
Other
Enumeration date
10/11/2006
Last updated
10/29/2013
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