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General NPI Number Information
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NPI Number | 1720460173
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Entity Type | Individual
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Provider Name | ADELAIDA MAGALLANES MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 5 PERRYRIDGE RD
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City | GREENWICH
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State | CT
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Zip | 06830-4608
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Country | US
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Telephone | 203-863-3972
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Fax | 203-863-4647
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Provider Business Mailing Address
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Address Line | 20 YORK STREET, CB-329
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-688-1734
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Fax | 475-246-9106
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 319090
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 79789
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60844924
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A148011
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License Number State | CA
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