Organization
PETER T. KRENICKY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER T KRENICKY M.D. (PRINCIPLE)
(860) 528-9645
Entity
Organization
Contact information
Practice address
477 CONNECTICUT BLVD., SUITE 205, EAST HARTFORD, CT 06108
(860) 528-9645
(860) 528-6366
Mailing address
477 CONNECTICUT BLVD., SUITE 205, EAST HARTFORD, CT 06108
(860) 528-9645
(860) 528-6366
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
013523
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001135235
—
CT
01
—
010013529CT
BCBS OF CT
CT
01
—
013523
CONNETICARE
CT
01
—
117584
EYEMED
CT
01
—
298521
WELLCARE
CT
Enumeration date
10/19/2010
Last updated
10/19/2010
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