Individual
LEELA PANOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
155 W MAIN ST, VERNON, CT 06066-3578
(860) 872-9825
(860) 870-9384
Mailing address
155 W MAIN ST, VERNON, CT 06066-3578
(860) 872-9825
(860) 870-9384
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
024173
CT
2084P0800X
Psychiatry Physician
Primary
024173
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001241736
—
CT
Enumeration date
06/24/2006
Last updated
07/12/2007
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