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Individual

DR. PETER T KRENICKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
477 CONNECTICUT BLVD, STE 205, EAST HARTFORD, CT 06108
(860) 528-9645
(860) 528-6366
Mailing address
477 CONNECTICUT BLVD, STE 205, EAST HARTFORD, CT 06108
(860) 528-9645
(860) 528-6366

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
13523
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001135235
CT
01
010013523CT
BCBS OF CT
01
013523
CONNECTICARE
Enumeration date
06/07/2006
Last updated
05/06/2010
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