Individual
ELANA CHLOE MCTAVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
(203) 384-3000
Mailing address
122 MEADOW HILLS DR, GUILFORD, CT 06437-1253
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
22237083
CT
Other
Enumeration date
09/10/2017
Last updated
11/05/2024
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