Provider Demographics
NPI:1326155367
Name:ALLARD, ELIZABETH K (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:K
Last Name:ALLARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4 SHAWS CV
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4956
Mailing Address - Country:US
Mailing Address - Phone:860-443-3778
Mailing Address - Fax:860-443-8820
Practice Address - Street 1:4 SHAWS CV
Practice Address - Street 2:SUITE 103
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4956
Practice Address - Country:US
Practice Address - Phone:860-443-3778
Practice Address - Fax:860-443-8820
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT041444207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001414440Medicaid
CTH28054Medicare UPIN
CT001414440Medicaid