Provider Demographics
NPI:1154399202
Name:DUFFY, ALLYSON N (MD)
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:N
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:345 NORTH MAIN ST
Mailing Address - Street 2:STE 248
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117
Mailing Address - Country:US
Mailing Address - Phone:860-231-8453
Mailing Address - Fax:860-523-4061
Practice Address - Street 1:345 NORTH MAIN ST
Practice Address - Street 2:STE 248
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117
Practice Address - Country:US
Practice Address - Phone:860-231-8453
Practice Address - Fax:860-523-4061
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0386742080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004058400Medicaid
CT010038674CT02OtherANTHEM BCBS
CT038674OtherCONNECTECARE