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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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