Healthcare Provider Details

I. General information

NPI: 1689503294
Provider Name (Legal Business Name): ALLISON J BEITEL, MD PLCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DOVER CT
CHESHIRE CT
06410-2849
US

IV. Provider business mailing address

6 DOVER CT
CHESHIRE CT
06410-2849
US

V. Phone/Fax

Practice location:
  • Phone: 203-499-7294
  • Fax:
Mailing address:
  • Phone: 203-499-7294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ALLISON BEITEL
Title or Position: OWNER/MANAGER
Credential: MD
Phone: 203-499-7294