Individual
DR. PETER THEODORE KANELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-6654
(860) 714-8110
Mailing address
14 SPRING LN, WEST HARTFORD, CT 06107-3341
(860) 904-9965
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0570757
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2008
Last updated
04/13/2012
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