Provider Demographics
NPI:1609838689
Name:WALLINGTON, DALE JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:JAMES
Last Name:WALLINGTON
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1216 FARMINGTON AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2672
Mailing Address - Country:US
Mailing Address - Phone:860-313-0134
Mailing Address - Fax:860-313-0134
Practice Address - Street 1:1216 FARMINGTON AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2672
Practice Address - Country:US
Practice Address - Phone:860-313-0134
Practice Address - Fax:860-313-0134
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2009-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0316942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF52510Medicare UPIN