Individual
MARK DENNIS V GERONIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 442-0711
(413) 543-7962
Mailing address
326 WASHINGTON ST, NORWICH, CT 06360-2740
(860) 442-0711
(413) 543-7962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036128606
IL
207Q00000X
Family Medicine Physician
2010024512
MO
207Q00000X
Family Medicine Physician
Primary
52895
CT
208M00000X
Hospitalist Physician
036128606
IL
208M00000X
Hospitalist Physician
52895
CT
Other
Enumeration date
06/21/2007
Last updated
07/22/2021
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