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Individual

DR. RENEE S KOHANSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11 MAIN ST, MYSTIC, CT 06355
(860) 334-4576
(855) 800-6850
Mailing address
11 MAIN ST, MYSTIC, CT 06355-3654
(860) 334-4576
(855) 800-6850

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
038625
CT
2084P0800X
Psychiatry Physician
Primary
038625
CT

Other

Enumeration date
05/14/2007
Last updated
08/26/2018
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