Individual
ELEAS J CHAFOULEAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
281 HARTFORD TPKE, SUITE 210, VERNON, CT 06066-4784
(860) 872-8563
(860) 870-4857
Mailing address
16 BIRCH HILL DR, TOLLAND, CT 06084-2439
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
041304
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041304
STATE LICENSE
CT
Enumeration date
07/10/2006
Last updated
07/08/2007
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