Provider Demographics
NPI:1821268996
Name:ALPHONSE D. ALTORELLI, M.D., P.C.
Entity Type:Organization
Organization Name:ALPHONSE D. ALTORELLI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALPHONSE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALTORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-868-7318
Mailing Address - Street 1:125 NEW MILFORD TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:NEW PRESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06777
Mailing Address - Country:US
Mailing Address - Phone:860-868-7318
Mailing Address - Fax:860-868-7310
Practice Address - Street 1:125 NEW MILFORD TURNPIKE
Practice Address - Street 2:
Practice Address - City:NEW PRESTON
Practice Address - State:CT
Practice Address - Zip Code:06777
Practice Address - Country:US
Practice Address - Phone:860-868-7318
Practice Address - Fax:860-868-7310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2023-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT022338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83227Medicare UPIN