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Individual

MR. EDWARD BARRY KRAVITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC, LAT

Contact information

Practice address
230 GEORGE ST, NEW HAVEN, CT 06510-3224
(203) 498-5980
Mailing address
466 S ELM ST, WALLINGFORD, CT 06492-4817
(860) 805-7259

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000118
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PROVIDER CODE 22
RESPIRATORY, REHABILITATI
CT
Enumeration date
04/10/2007
Last updated
07/08/2007
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