Individual
ELIZABETH DEGNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 SOUTH RD, FARMINGTON, CT 06032-2482
(617) 638-6500
Mailing address
21 SOUTH RD STE 110, FARMINGTON, CT 06032-2482
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
77579
CT
207R00000X
Internal Medicine Physician
ETLL-570
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
077579
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2020
Last updated
10/15/2024
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