Healthcare Provider Details

I. General information

NPI: 1851411169
Provider Name (Legal Business Name): BRANFORD PEDIATRICS & ALLERGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 E MAIN ST
BRANFORD CT
06405-2918
US

IV. Provider business mailing address

784 E MAIN ST
BRANFORD CT
06405-2918
US

V. Phone/Fax

Practice location:
  • Phone: 203-481-7008
  • Fax:
Mailing address:
  • Phone: 203-481-7008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHY F. BAINER
Title or Position: ADMINISTRATIVE MANAGER
Credential:
Phone: 203-481-7008