Individual
DR. ANRI ARONOVITCH KISSILENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
208 VALLEY RD, NEW CANAAN, CT 06840-3812
(203) 801-2235
Mailing address
12 QUINCY LN, WHITE PLAINS, NY 10605-5430
(914) 946-9525
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036852
CT
2084P0800X
Psychiatry Physician
204449
NY
2084P0805X
Geriatric Psychiatry Physician
036852
CT
2084P0805X
Geriatric Psychiatry Physician
204449
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260041014
RAILROAD MEDICARE
GA
01
—
618725
TRIGON BCBS
—
Enumeration date
10/06/2006
Last updated
09/07/2016
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