Healthcare Provider Details

I. General information

NPI: 1821268996
Provider Name (Legal Business Name): ALPHONSE D. ALTORELLI, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 08/19/2023
Certification Date: 08/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 NEW MILFORD TURNPIKE
NEW PRESTON CT
06777
US

IV. Provider business mailing address

125 NEW MILFORD TURNPIKE
NEW PRESTON CT
06777
US

V. Phone/Fax

Practice location:
  • Phone: 860-868-7318
  • Fax: 860-868-7310
Mailing address:
  • Phone: 860-868-7318
  • Fax: 860-868-7310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number022338
License Number StateCT

VIII. Authorized Official

Name: DR. ALPHONSE DAVID ALTORELLI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-868-7318