Individual
KEVIN MICHAEL GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(203) 573-6205
Mailing address
140 GRISWOLD DRIVE, WEST HARTFORD, CT 06119
(716) 983-7115
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
047604
CT
Other
Enumeration date
05/18/2007
Last updated
06/01/2012
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