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Individual

DR. TRACEY EDAN KRASNOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 BLUE HILLS AVE, HARTFORD, CT 06112-1500
(860) 714-3616
Mailing address
365 W MOUNTAIN RD, WEST SIMSBURY, CT 06092-2910
(317) 696-3757

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01063613A
IN
2084P0800X
Psychiatry Physician
01063613A
IN
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
01063613A
IN

Other

Enumeration date
05/21/2007
Last updated
05/01/2009
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