Kenneth Scott Backman
Allergist & Immunologist
55 Walls Dr Ste. 405
Fairfield
, Connecticut 06824-5163
Kenneth Scott Backman
Allergist & Immunologist
55 Walls Dr Ste. 405
Fairfield
, Connecticut 06824-5163
(203) 254-7402
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About
Features
Specialties
- Allergist & Immunologist
Languages spoken
- English
Location
First Address
- Kenneth Scott Backman
- 55 Walls Dr Ste. 405
- Fairfield, CT
- Zip : 06824-5163
- Fax : (203) 254-7402
- Phone : (203) 259-7070
Second Address
- Kenneth Scott Backman
- 55 Walls Dr Ste. 405
- Fairfield, CT
- Zip : 06824-5163
- Fax : (203) 254-7402
- Phone : (203) 259-7070
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | 038854 | CT |
National Provider Identifier
| NPI | 1174595847 |
|---|---|
| Provider Name | Kenneth Scott Backman |
| First Address | Fairfield, CT 06824-5163 |
| Second Address | Fairfield, CT 06824-5163 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/02/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 010038854CT02 | BLUE CROSS/BLUE SHIELD (01) | CT |
| G35188 | (02) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.