Provider Demographics
NPI:1417381823
Name:HELLER, ALLEN HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:HARVEY
Last Name:HELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HUNTERS RDG
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1942
Mailing Address - Country:US
Mailing Address - Phone:203-389-6434
Mailing Address - Fax:203-389-2324
Practice Address - Street 1:6 HUNTERS RDG
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-1942
Practice Address - Country:US
Practice Address - Phone:203-389-6434
Practice Address - Fax:203-389-2324
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine