Individual
DR. ELVIN MATHEW SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 423-7558
Mailing address
775 MIX AVE APT C, HAMDEN, CT 06514-2121
(516) 639-3552
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
009820
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
685847-01
NY
367500000X
Certified Registered Nurse Anesthetist
STUDENT
CT
Other
Enumeration date
06/30/2021
Last updated
09/13/2022
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