Individual
GREGORY ROBERT GUSTAVSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2040
(860) 456-9116
Mailing address
5 BEAUDET TER, COLUMBIA, CT 06237-1404
(860) 617-0730
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
12.017664
CT
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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