Individual
LEONID KARKANITSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6580 MAIN ST FL 1, STRATFORD, CT 06614
(203) 377-5444
(203) 377-5540
Mailing address
6580 MAIN ST FL 1, STRATFORD, CT 06614-1607
(203) 377-5444
(203) 377-5540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
043534
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004256302
—
CT
01
—
C03462
MEDICARE PTAN
CT
01
—
D300080683
MEDICARE
CT
Enumeration date
04/07/2006
Last updated
07/24/2018
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