Provider Demographics
NPI:1285748434
Name:ALLEN, HENRY COLEMAN (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:COLEMAN
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 PROSPECT HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3715
Mailing Address - Country:US
Mailing Address - Phone:860-350-4000
Mailing Address - Fax:860-355-5581
Practice Address - Street 1:10 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-3715
Practice Address - Country:US
Practice Address - Phone:860-350-4000
Practice Address - Fax:860-355-5581
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT028978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00128978600Medicaid