Gensicki, Edward Stanley

Gensicki, Edward Stanley is an sole proprietor health care provider with primary practice located at 1812 Dixwell Ave , Hamden CT 06514-3105. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Gensicki, Edward Stanley can be contacted via phone (203) 287-0336.

Contact Information

Primary practice address
1812 Dixwell Ave Hamden CT 06514-3105
Phone: (203) 287-0336
Fax: (203) 287-0387
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X P00369 Connecticut

Profile Details

NPI number 1982632634
LBN Legal business name Gensicki, Edward Stanley
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2006
Last updated Feb 15th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982632634 NPPES
Connecticut Other 000369-7413 CONNECTICARE
Connecticut Other 183481 CONNECTICARE
Connecticut Other P778784 CONNECTICARE
Connecticut MEDICAID 004067245 CONNECTICARE
Connecticut Other 030000369CT01 CONNECTICARE
Connecticut Other P00369 CONNECTICARE
Connecticut Other 0V1575 CONNECTICARE
Connecticut Other 4800009967 CONNECTICARE

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