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Individual
DR. EDWARD STANLEY GENSICKI
Active
Individual
DR. EDWARD STANLEY GENSICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P00369
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000369-7413
CONNECTICARE
CT
05
—
004067245
—
CT
01
—
030000369CT01
ANTHEM BC
CT
01
—
0V1575
HEALTH NET
CT
01
—
183481
WELLCARE
CT
01
—
4800009967
RR MEDICARE
—
01
—
P00369
STATE LICENSE
CT
01
—
P778784
OXFORD
—
Enumeration date
06/30/2006
Last updated
02/15/2008
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