Provider Demographics
NPI:1346359015
Name:BEITEL, ALLISON J (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:J
Last Name:BEITEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:97 BARNES ROAD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492
Mailing Address - Country:US
Mailing Address - Phone:203-265-9890
Mailing Address - Fax:203-265-3321
Practice Address - Street 1:97 BARNES ROAD
Practice Address - Street 2:SUITE 6
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-265-9890
Practice Address - Fax:203-265-3321
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT042105208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics