Provider Demographics
NPI:1871505313
Name:GENSER, STUART S (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:S
Last Name:GENSER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 FARM SPRINGS RD
Mailing Address - Street 2:PROHEALTH PHYSICIANS
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5200
Mailing Address - Fax:860-284-5333
Practice Address - Street 1:631 QUAKER LN S
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1026
Practice Address - Country:US
Practice Address - Phone:860-233-5133
Practice Address - Fax:860-233-5212
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT019476207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83492Medicare UPIN