Individual
ELISE WINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
520 HARTFORD TPKE, SUITE M, VERNON, CT 06066-5037
(860) 872-8321
(860) 875-6271
Mailing address
520 HARTFORD TPKE, SUITE M, VERNON, CT 06066-5037
(860) 872-8321
(860) 875-6271
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
002622
CT
363A00000X
Physician Assistant
Primary
002622
CT
363AS0400X
Surgical Physician Assistant
—
CT
Other
Enumeration date
08/11/2011
Last updated
07/16/2014
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