Provider Demographics
NPI:1801055231
Name:ALLERGY & ASTHMA ASSOCIATES OF STAMFORD, P.C/
Entity type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES OF STAMFORD, P.C/
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD/
Authorized Official - Phone:203-324-9525
Mailing Address - Street 1:144 MORGAN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5433
Mailing Address - Country:US
Mailing Address - Phone:203-324-9525
Mailing Address - Fax:203-324-0797
Practice Address - Street 1:144 MORGAN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5433
Practice Address - Country:US
Practice Address - Phone:203-324-9525
Practice Address - Fax:203-324-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028644207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty