Gregory Richard Criscuolo Jr., PA-C
Physician Assistant in New Britain, CT. Individual provider (NPI-1).
NPI number1962829101
StatusActive
Last updated in NPPESOct 11, 2019
Details
- NPI
- 1962829101
- Entity type
- Individual (NPI-1)
- Name
- Mr. Gregory Richard Criscuolo Jr.
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 26, 2014
- Last updated
- Oct 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 3047 | CT | Yes |
Practice location
1 Lake StNew Britain, CT 06052-1396
Phone 860-258-3470
Mailing address
360 Bloomfield AveSte 209
Windsor, CT 06095-2700
Phone 860-258-3470
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