Individual
MR. GREGORY RICHARD CRISCUOLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 LAKE ST, NEW BRITAIN, CT 06052-1396
(860) 258-3470
Mailing address
360 BLOOMFIELD AVE, STE 209, WINDSOR, CT 06095-2700
(860) 258-3470
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3047
CT
Other
Enumeration date
03/26/2014
Last updated
10/11/2019
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