Healthcare Provider Details

I. General information

NPI: 1750581039
Provider Name (Legal Business Name): ANDREW J. PARKER, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 04/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 EAST AVE
NORWALK CT
06851-5721
US

IV. Provider business mailing address

148 EAST AVE
NORWALK CT
06851-5721
US

V. Phone/Fax

Practice location:
  • Phone: 203-866-8121
  • Fax: 203-866-4193
Mailing address:
  • Phone: 203-866-8121
  • Fax: 203-866-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW JUSTIN PARKER
Title or Position: M.D.
Credential: M.D.
Phone: 203-866-8121