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IHOR NICHOLAS PONOMARENKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
350 SEYMOUR AVE, SUITE 101, DERBY, CT 06418-1336
(203) 732-3443
(203) 732-4011
Mailing address
350 SEYMOUR AVE, SUITE 101, DERBY, CT 06418-1336
(203) 732-3443
(203) 732-4011

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
041556
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001415563
CT
Enumeration date
07/03/2006
Last updated
05/31/2013
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