Individual
DR. ELLEN MASCOLI-LANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
160 ROBBINS ST, WATERBURY, CT 06708-2652
(203) 755-2999
(203) 346-6971
Mailing address
160 ROBBINS ST, WATERBURY, CT 06708-2652
(203) 755-2999
(203) 346-6971
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
032687
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010032687CT02
BLUECROSS BLUESHIELD
CT
01
—
0R1134
HEALTHNET
CT
01
—
689184
CONNECTICARE
CT
01
—
NHP175
OXFORD
CT
Enumeration date
08/27/2006
Last updated
04/15/2008
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