Provider Demographics
NPI:1124021183
Name:ALBERTI, ALFRED RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:RICHARD
Last Name:ALBERTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:ALBERTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-832-8150
Mailing Address - Fax:860-224-6298
Practice Address - Street 1:300 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3916
Practice Address - Country:US
Practice Address - Phone:860-832-8150
Practice Address - Fax:860-224-6298
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010022817CT01OtherBCBS & BCFP PROV ID
CT1022817OtherCIGNA
CT004215324Medicaid
CT001228170Medicaid
CT060072OtherHEALTH NET
CT368257OtherWELLCARE MEDICARE
CTP369852OtherOXFORD
CT1255448155OtherGHMC GROUP NPI
CT476780OtherAETNA
CT5002001OtherCONNECTICARE
CT110001041Medicare ID - Type Unspecified
CT368257OtherWELLCARE MEDICARE
CTD77074Medicare UPIN