Individual
ENRIQUE J TELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 WASHINGTON AVE, SUITE 304, HAMDEN, CT 06518-3271
(203) 281-2890
(203) 281-2896
Mailing address
60 WASHINGTON AVE, SUITE 304, HAMDEN, CT 06518-3271
(203) 281-2890
(203) 281-2896
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
040565
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260004862
MEDICARE ID PTAN
CT
Enumeration date
10/11/2005
Last updated
06/11/2014
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