Individual
ELMO VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 CROMWELL AVE, ROCKY HILL, CT 06067-1851
(860) 529-1287
(860) 721-6311
Mailing address
506 CROMWELL AVE, ROCKY HILL, CT 06067-1851
(860) 529-1287
(860) 721-6311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
035713
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001357137
—
CT
01
—
010035713CT03
ANTHEM BLUE SHIELD
TN
01
—
0V6230
HEALTHNET
—
Enumeration date
07/23/2006
Last updated
06/21/2021
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