Provider Demographics
NPI:1740834506
Name:ALLEDRAN MEDICAL LLC
Entity type:Organization
Organization Name:ALLEDRAN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMAIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-605-5236
Mailing Address - Street 1:76 EASTERN BLVD UNIT D
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4382
Mailing Address - Country:US
Mailing Address - Phone:203-605-5236
Mailing Address - Fax:860-540-1635
Practice Address - Street 1:76 EASTERN BLVD UNIT D
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4382
Practice Address - Country:US
Practice Address - Phone:203-605-5236
Practice Address - Fax:860-540-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies