Healthcare Provider Details

I. General information

NPI: 1710969282
Provider Name (Legal Business Name): ELLEN SALURAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 ROUTE 171
WOODSTOCK CT
06281-3123
US

IV. Provider business mailing address

168 ROUTE 171
WOODSTOCK CT
06281-3123
US

V. Phone/Fax

Practice location:
  • Phone: 860-928-7775
  • Fax: 860-928-1397
Mailing address:
  • Phone: 860-928-7775
  • Fax: 860-928-1397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number161268
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number38227
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: