Luis Alonso, MD
Individual provider Active NPI Pediatrics Physician · Wallingford, CT
NPI 1992864359 · NPPES record last updated Jul 7, 2011
Key facts
- NPI
- 1992864359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 016387 (CT)
- Practice address
- 1062 Barnes Road
Suite 102
Wallingford, CT 06492 - Phone
- (203) 294-6328
- Fax
- (203) 294-6346
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016387 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luis Alonso MD PC | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 016387 | CT | Yes |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 016387 | CT |
Addresses
Primary practice location
1062 Barnes Road
Suite 102
Wallingford, CT 06492
Mailing address
1062 Barnes Road
Suite 102
Wallingford, CT 06492
Phone (203) 294-6328
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0Q2160 | Other | HEALTHNET | |
| P387376 | Other | OXFORD | |
| 749832 | Other | CONNECTICARE | |
| 83192 | Other | AETNA | |
| 001163872 | Medicaid | CT |
Other providers in Wallingford, CT
- Alan D Schupack DDS LLC
- Janine M Albanese
- Alfredo L. Axtmayer M.D. P.C.
- All-Med Healthcare Inc
- Alleviate Pain and Wellness
- Alpha Dental Group, P.C.
- Alyssa Axelrod LCSW LLC
- Gina Amante
- Kristen Maria Amarone
- Melinda Amato
All providers in Wallingford, CT · Pediatrics Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.