Provider Demographics
NPI:1639104680
Name:CZARSTY, CRAIG W (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:W
Last Name:CZARSTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MAIN STREET
Mailing Address - Street 2:HEALTH ONE PHYSICIAN ASSOCIATES PC OAKVILLE FAMILY PHYS
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779
Mailing Address - Country:US
Mailing Address - Phone:860-274-3344
Mailing Address - Fax:860-945-0507
Practice Address - Street 1:314 MAIN STREET
Practice Address - Street 2:HEALTH ONE PHYSICIAN ASSOCIATES PC OAKVILLE FAMILY PHYS
Practice Address - City:OAKVILLE
Practice Address - State:CT
Practice Address - Zip Code:06779
Practice Address - Country:US
Practice Address - Phone:860-274-3344
Practice Address - Fax:860-945-0507
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT24377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001243773Medicaid
CT080173201OtherRAILROAD MEDICARE
CT080001301Medicare PIN
CT080173201OtherRAILROAD MEDICARE