Healthcare Provider Details

I. General information

NPI: 1720395320
Provider Name (Legal Business Name): ALLERGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 YORK ST SUITE 2 F
NEW HAVEN CT
06511-5620
US

IV. Provider business mailing address

100 YORK ST SUITE 2 F
NEW HAVEN CT
06511-5620
US

V. Phone/Fax

Practice location:
  • Phone: 203-777-6455
  • Fax: 203-789-1960
Mailing address:
  • Phone: 203-777-6455
  • Fax: 203-789-1960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number13422
License Number StateCT

VIII. Authorized Official

Name: DR. PHILIP ISRAEL WEISINGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 203-777-6455