MEDICARE: ALLISON PADEGIMAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	66317	CT

General Provider Information

NPI Number	:	1144630328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON PADEGIMAS M.D.

Provider Business Mailing Address
First Line	:	1062 BARNES RD
Second Line	:	STE 300
City	:	WALLINGFORD
State	:	CT
Zip	:	06492-2576
Country	:	US
Telephone Number	:	203-265-9831
Fax Number	:	203-265-2977

Provider Business Practice Location Address
First Line	:	1062 BARNES RD STE 300
Second Line	:
City	:	WALLINGFORD
State	:	CT
Zip	:	06492-2576
Country	:	US
Telephone Number	:	203-265-9831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	09/11/2020

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