Provider Demographics
NPI:1912940784
Name:THOMAS R. ALOSCO, M.D., P.C.
Entity Type:Organization
Organization Name:THOMAS R. ALOSCO, M.D., P.C.
Other - Org Name:THOMAS R. ALOSCO, M.D., P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-574-0400
Mailing Address - Street 1:1336 W MAIN ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3122
Mailing Address - Country:US
Mailing Address - Phone:203-574-0400
Mailing Address - Fax:203-574-0406
Practice Address - Street 1:1336 W MAIN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3122
Practice Address - Country:US
Practice Address - Phone:203-574-0400
Practice Address - Fax:203-574-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033906174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE62925Medicare UPIN
C02712Medicare ID - Type Unspecified