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Individual

ELIZABETH ANN WHALEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 KENNEDY DR, LOWER LEVEL, TORRINGTON, CT 06790-3096
(860) 489-6718
(860) 489-8270
Mailing address
200 KENNEDY DR, LOWER LEVEL, TORRINGTON, CT 06790-3096
(860) 489-6718
(860) 489-8270

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
032771
CT
2085R0203X
Therapeutic Radiology Physician
032771
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001327718
CT
Enumeration date
06/11/2006
Last updated
12/01/2020
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