Allercenter 1 LLC

Primary specialty

Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X

License

044806 Issued in CT

Legal business name

ALLERCENTER 1 LLC

Practice address

35 Mill Stone Cir
Stamford, CT 06903-3513

Phone

(203) 667-3192

NPI assigned

Jun 12, 2014

Last updated

Jun 12, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cimmaron Merritt

Title

Compliance Officer

Phone

(203) 667-3192

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1376957894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MILL STONE CIR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069033513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MILL STONE CIR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069033513",
            "telephone_number": "203-667-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERCENTER 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "CIMMARON",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "203-667-3192"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "CT",
            "license": "044806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology (Internal Medicine) Physician in Stamford, CT
• Providers in Stamford, CT by specialty
• Allergy & Immunology (Internal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.