Provider Demographics
NPI:1235333055
Name:RACCIO, ELAINE (BC-HIS)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:RACCIO
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ROME LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-6114
Mailing Address - Country:US
Mailing Address - Phone:203-888-7803
Mailing Address - Fax:
Practice Address - Street 1:69 SAND PIT RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4004
Practice Address - Country:US
Practice Address - Phone:203-791-2020
Practice Address - Fax:203-778-6238
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000384237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060945561OtherFED TAX ID