Individual
ATHANASIA D SYRENGELAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
210 NEW LONDON TPKE, GLASTONBURY, CT 06033-2235
(860) 633-1543
(860) 659-9755
Mailing address
210 NEW LONDON TPKE, GLASTONBURY, CT 06033-2235
(860) 633-1543
(860) 659-9755
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
041159
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010041159CT02
ANTHEM BCBS
CT
01
—
041159
CONNECTICARE
CT
01
—
3681270
AETNA
CT
Enumeration date
09/13/2005
Last updated
07/08/2007
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