Provider Demographics
NPI:1932292752
Name:ELLIOT C. ZWEIG, M.D.,P.C.
Entity Type:Organization
Organization Name:ELLIOT C. ZWEIG, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-561-0580
Mailing Address - Street 1:41 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1972
Mailing Address - Country:US
Mailing Address - Phone:860-561-0580
Mailing Address - Fax:860-521-1142
Practice Address - Street 1:41 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1972
Practice Address - Country:US
Practice Address - Phone:860-561-0580
Practice Address - Fax:860-521-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT019419207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38529Medicare UPIN