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Individual

MR. ROBERT MYRON ELISOFON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
38 B GROVE ST, RIDGEFIELD, CT 06877
(203) 438-9557
(203) 438-7857
Mailing address
38 B GROVE ST, RIDGEFIELD PEDIATRIC ASSOCIATES, RIDGEFIELD, CT 06877
(203) 438-9557
(203) 438-7857

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
016398
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00163989
CT
Enumeration date
02/08/2006
Last updated
07/08/2007
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