Center for Allergy Asthma & Immunology LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

027063 Issued in CT

Legal business name

CENTER FOR ALLERGY ASTHMA & IMMUNOLOGY LLC

Practice address

1389 W Main St
Waterbury, CT 06708-3104

Phone

(203) 755-7080

Fax

(203) 597-5422

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Croin Randolph, M.D.

Title

Ceo

Phone

(203) 755-7080

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1932297298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "address_2": "SUITE 205",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-755-7080",
            "fax_number": "203-597-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1389 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083104",
            "telephone_number": "203-755-7080",
            "fax_number": "203-597-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ALLERGY ASTHMA & IMMUNOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "CROIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-755-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "CT",
            "license": "027063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Allergy & Immunology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.