Individual
DR. LUIS A. AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
Mailing address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
027349
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001273490
—
CT
Enumeration date
08/09/2006
Last updated
06/21/2012
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