Healthcare Provider Details

I. General information

NPI: 1548174881
Provider Name (Legal Business Name): ELAINE FOPPE CT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DALE RD STE 101
AVON CT
06001-3692
US

IV. Provider business mailing address

29 DUNHAM RD PO BOX 1150
WARREN MA
01083-7947
US

V. Phone/Fax

Practice location:
  • Phone: 860-268-2577
  • Fax:
Mailing address:
  • Phone: 860-268-2577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number006903
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: