Individual
VICTOR ELI VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
580 COTTAGE GROVE RD STE 107, BLOOMFIELD, CT 06002-3088
(860) 243-8709
(860) 243-8259
Mailing address
209 VICTORIA RD, HARTFORD, CT 06114-2800
(860) 712-8131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5936
CT
363AM0700X
Medical Physician Assistant
Primary
5936
CT
363AS0400X
Surgical Physician Assistant
5936
CT
Other
Enumeration date
01/10/2023
Last updated
04/24/2024
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