Individual
KIRAN A LORICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 WOODLAND ST, HARTFORD, CT 06105-1207
(860) 714-4212
(860) 714-8080
Mailing address
99 WOODLAND ST, HARTFORD, CT 06105-1207
(860) 714-4212
(860) 714-8080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72411
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72411
LICENSE
CT
Enumeration date
04/01/2019
Last updated
09/01/2022
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