Individual
ELCON LEVINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 TOWNE PARK PLZ, NORWICH, CT 06360-2247
(860) 886-1433
(860) 886-4644
Mailing address
26 SAINT ANDREWS DR, AVON, CT 06001-4050
(860) 673-0682
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
039506
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001173129
—
CT
01
—
007060083
MEDICARE PROVIDER NUMBER-RI
RI
01
—
04120
NEIGHBORHOOD
RI
01
—
1600097
UNITED HEALTH
RI
01
—
327060
BCBS
RI
01
—
411814
MEDICARE GROUP
RI
01
—
414191
BCHIP
RI
05
—
EL67101
—
RI
Enumeration date
09/28/2006
Last updated
05/27/2008
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