Healthcare Provider Details

I. General information

NPI: 1255534855
Provider Name (Legal Business Name): ARON FLAGG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2007
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST PEDIATRIC HEM ONC SUITE 7TH FL
NEW HAVEN CT
06511
US

IV. Provider business mailing address

141 WILDCAT RD
MADISON CT
06443-2471
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-4640
  • Fax: 203-737-2228
Mailing address:
  • Phone: 216-633-2476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.091439
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number62157
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: