Individual
DR. GLENN KONOPASKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UCONN HEALTH, DEPT. OF PSYCHIATRY, 263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-1105
(860) 679-1489
Mailing address
189 STORRS RD, MANSFIELD CENTER, CT 06250-1683
(860) 456-1311
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
40112
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013004610001
—
PA
Enumeration date
03/14/2006
Last updated
09/26/2022
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