Provider Demographics
NPI:1194945063
Name:DOBRITA, ALINA ILEANA (MD)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:ILEANA
Last Name:DOBRITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:ILEANA
Other - Last Name:BALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 W AVON RD
Mailing Address - Street 2:STE 301
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3679
Mailing Address - Country:US
Mailing Address - Phone:860-404-2905
Mailing Address - Fax:860-470-3198
Practice Address - Street 1:46 W AVON RD
Practice Address - Street 2:STE 301
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3679
Practice Address - Country:US
Practice Address - Phone:860-404-2905
Practice Address - Fax:860-470-3198
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045219207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1194945063OtherNPI