Individual
DANIEL E. PETASHNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
732 MAIN ST, MANCHESTER, CT 06040-5106
(860) 649-5177
(860) 664-3490
Mailing address
732 MAIN ST, MANCHESTER, CT 06040-5106
(860) 649-5177
(860) 664-3490
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
035638
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001356387
—
CT
05
—
1437186251
—
CT
Enumeration date
06/27/2006
Last updated
02/04/2022
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