Grodofsky, Marshall P

Grodofsky, Marshall P is an individual health care provider with primary practice located at 836 Farmington Avenue Suite 207, West Hartford CT 06119. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology, Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Grodofsky, Marshall P can be contacted via phone (860) 232-9911.

Contact Information

Primary practice address
836 Farmington Avenue Suite 207 West Hartford CT 06119
Phone: (860) 232-9911
Fax: (860) 233-5996
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 027137 Connecticut
Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology 207KI0005X 027137 Connecticut
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X 27137 Connecticut
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 027137 Connecticut

Profile Details

NPI number 1841271699
LBN Legal business name Grodofsky, Marshall P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Aug 25th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841271699 NPPES
Connecticut MEDICAID 001271378
Connecticut Other 0585739002
Connecticut Other P1870457
Connecticut MEDICAID OS2228
Connecticut MEDICAID 00127137800
Connecticut Other 010027137CT01
Connecticut Other 020138
Connecticut Other 216970

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