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Individual

DR. LENWORTH RANSFORD ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
UCONN MEDICAL GROUP, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474
Mailing address
UCONN MEDICAL GROUP, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-4474

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041803
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001418038
CT
Enumeration date
07/15/2006
Last updated
03/03/2016
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