Individual
CHRISTOPHER GENNINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
300 SEASIDE AVE, MILFORD, CT 06460-4603
(203) 876-4100
(203) 876-4128
Mailing address
300 SEASIDE AVE, MILFORD, CT 06460-4603
(203) 876-4100
(203) 876-4128
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
039660
CT
207Q00000X
Family Medicine Physician
Primary
039660
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396605
UPIN #
CT
01
—
31306
CONTROL SUBSTANCE
CT
Enumeration date
08/20/2006
Last updated
07/28/2020
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