Individual
GREGORY MICHAEL RICKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1625 STRAITS TPKE STE 200, MIDDLEBURY, CT 06762-1836
(203) 568-2929
(203) 575-5121
Mailing address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(203) 573-6162
(203) 573-6707
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
67612
CT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/12/2014
Last updated
08/09/2021
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