Provider Demographics
NPI:1407878754
Name:ALBERGO, PATRICK F (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:F
Last Name:ALBERGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:639 PARK RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-3443
Mailing Address - Country:US
Mailing Address - Phone:860-521-9230
Mailing Address - Fax:860-521-1709
Practice Address - Street 1:639 PARK RD
Practice Address - Street 2:SUITE #100
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-3443
Practice Address - Country:US
Practice Address - Phone:860-521-9230
Practice Address - Fax:860-521-1709
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT029084174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT180000344OtherPTAN
CT1290840Medicaid
CT1290840Medicaid