Provider Demographics
NPI:1225418791
Name:STROH, INNA GRISHKAN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:GRISHKAN
Last Name:STROH
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:INNA
Other - Middle Name:V
Other - Last Name:GRISHKAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:499 FARMINGTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1933
Mailing Address - Country:US
Mailing Address - Phone:860-678-0202
Mailing Address - Fax:860-678-0277
Practice Address - Street 1:499 FARMINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1933
Practice Address - Country:US
Practice Address - Phone:860-678-0202
Practice Address - Fax:860-678-0277
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-31
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11166860-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology