Individual
KELVIN DIAZ PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
263 FARMINGTON AVENUE, FARMINGTON, CT 06030
(860) 679-2784
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
80386
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2019
Last updated
08/04/2025
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