Healthcare Provider Details

I. General information

NPI: 1700894177
Provider Name (Legal Business Name): ROGER H KARLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 ROUTE 37
NEW FAIRFIELD CT
06812
US

IV. Provider business mailing address

88 ROUTE 37
NEW FAIRFIELD CT
06812
US

V. Phone/Fax

Practice location:
  • Phone: 203-746-2436
  • Fax: 203-746-3205
Mailing address:
  • Phone: 203-746-2436
  • Fax: 203-746-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number19394
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19394
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: