Individual
ELECTRA VESON KALOUDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-2803
(860) 679-2784
(860) 679-4126
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
048681
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811163678
—
CT
Enumeration date
05/01/2008
Last updated
11/07/2022
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