Allergy and Asthma Consultants of Fairfield County, LLC

Organization Active NPI Allergy & Immunology Physician · Fairfield, CT

NPI 1992043483 · NPPES record last updated May 9, 2013

Key facts

NPI
1992043483
Entity type
Organization (NPI type 2)
Primary specialty
Allergy & Immunology Physician 207K00000X
Legal business name
ALLERGY AND ASTHMA CONSULTANTS OF FAIRFIELD COUNTY, LLC
Practice address
140 Sherman St FL 3
Fairfield, CT 06824-5849
Phone
(203) 955-1461
Fax
(203) 955-1464
NPI assigned
Jan 18, 2013
Organization subpart
No

Authorized official

Name
Dr. Aimee Altschul-Latzman, M.D. NPI 1003855859
Title
Physician Sole Member
Phone
(646) 872-6795

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130619000443 CT Part B Supplier - Clinic/Group Practice 4880833078 Receives reassigned benefits from 1 practitioner
Practice locations: Fairfield, CT

National Provider Directory

Locations

140 Sherman St
Fl 3
Fairfield, CT 06824
Phone (203) 538-5682

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207K00000X CT Yes

Addresses

Primary practice location

140 Sherman St FL 3
Fairfield, CT 06824-5849

Mailing address

140 Sherman St FL 3
Fairfield, CT 06824-5849
Phone (203) 955-1461

Other identifiers

IdentifierTypeStateIssuer
1003855859OtherCTINDIVIDUAL NPI NUMBER

Other providers in Fairfield, CT

All providers in Fairfield, CT · Allergy & Immunology Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.