Healthcare Provider Details

I. General information

NPI: 1235353426
Provider Name (Legal Business Name): ALLERGY CENTER OF CONNECTICUT, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 MAIN ST
BRIDGEPORT CT
06606-1813
US

IV. Provider business mailing address

4675 MAIN ST
BRIDGEPORT CT
06606-1813
US

V. Phone/Fax

Practice location:
  • Phone: 203-374-6104
  • Fax: 203-374-1663
Mailing address:
  • Phone: 203-374-6104
  • Fax: 203-374-1663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP HEMMERS
Title or Position: OWNER
Credential: D.O.
Phone: 203-374-6103