Dr Benoit D Tano, MD, PHD | |
622 Hebron Ave, Glastonbury, CT 06033-2421 | |
(860) 659-8904 | |
Not Available |
Full Name | Dr Benoit D Tano |
---|---|
Gender | Male |
Speciality | Allergy & Immunology |
Location | 622 Hebron Ave, Glastonbury, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457419616 | NPI | - | NPPES |
M4963 | Other | TEXAS MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RA0201X | Internal Medicine - Allergy & Immunology | PT11501 (North Dakota) | Secondary |
207K00000X | Allergy & Immunology | M4963 (Texas) | Primary |
Entity Name | Integrative Immunity Health System Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265802052 PECOS PAC ID: 7911209259 Enrollment ID: O20160105000050 |
Mailing Address | Practice Location Address |
---|---|
Dr Benoit D Tano, MD, PHD 622 Hebron Ave, Glastonbury, CT 06033-2421 Ph: (860) 659-8904 | Dr Benoit D Tano, MD, PHD 622 Hebron Ave, Glastonbury, CT 06033-2421 Ph: (860) 659-8904 |
Kelly Heilman, APRN Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 131 New London Tpke Ste 101, Glastonbury, CT 06033 Phone: 860-659-8904 Fax: 860-246-5828 | |
Dr. Prasad Srinivasan, MD Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 131 New London Tpke Ste 101, Glastonbury, CT 06033 Phone: 860-659-8904 |