Provider Demographics
NPI:1891792529
Name:SPRECACE, GEORGE A (MD JD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:SPRECACE
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Gender:M
Credentials:MD JD
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Mailing Address - Street 1:196 PARKWAY S
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1234
Mailing Address - Country:US
Mailing Address - Phone:860-442-7027
Mailing Address - Fax:860-444-0074
Practice Address - Street 1:400 BAYONET ST
Practice Address - Street 2:SUITE LL2
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-2600
Practice Address - Country:US
Practice Address - Phone:860-443-0769
Practice Address - Fax:860-443-1278
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-02-26
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Provider Licenses
StateLicense IDTaxonomies
CT011104207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38411Medicare UPIN
CT110000422Medicare PIN