Provider Demographics
NPI:1508174624
Name:ELUVATHINGAL, JOSE LONAPPAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:LONAPPAN
Last Name:ELUVATHINGAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1526
Mailing Address - Country:US
Mailing Address - Phone:262-637-8888
Mailing Address - Fax:262-637-0695
Practice Address - Street 1:800 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1526
Practice Address - Country:US
Practice Address - Phone:262-637-8888
Practice Address - Fax:262-637-0695
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health