ELLEN G. POLOKOFF MD, LLC
Radiology at Main St, Southbury, CT

License number
Connecticut 035653
Category
Radiology
Type
Surgery
Owner
Name: ELLEN POLOKOFF
Title: PHYSICIAN OWNER
Phone: (203) 262-2300
Address
Address
900 Main St S, Southbury, CT 06488
National Provider ID: 1407054950
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ELLEN G. POLOKOFF, M.D., LLC

900 Main St S, Southbury, CT 06488

Registration:
Jan 9, 2007
State ID:
0884249
Business type:
Domestic Limited Liability Company
MEMBER:
Ellen G. Polokoff, M.d (MEMBER), 900 Main St S, Southbury, CT 06488 (Mailing)
82 Hampton Ct, Southbury, CT 06488 (Physical)
Agent:
Alice J. Mick, Esq,271 Whitney Ave, New Haven, CT 06511 (Mailing)
100 Ogden St, New Haven, CT 06511 (Physical)

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