Individual
GARY M TICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
166 NEEDLETREE LN, GLASTONBURY, CT 06033-3535
(203) 331-6789
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
027615
CT
Other
Enumeration date
10/23/2006
Last updated
02/22/2015
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