Provider Demographics
NPI:1013955012
Name:CONNECTICUT NEUROLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:CONNECTICUT NEUROLOGY CONSULTANTS PC
Other - Org Name:MICHAEL M KRINSKY MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-243-9709
Mailing Address - Street 1:580 COTTAGE GROVE RD
Mailing Address - Street 2:#106
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3088
Mailing Address - Country:US
Mailing Address - Phone:860-243-9709
Mailing Address - Fax:860-243-2522
Practice Address - Street 1:580 COTTAGE GROVE RD
Practice Address - Street 2:#106
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3088
Practice Address - Country:US
Practice Address - Phone:860-243-9709
Practice Address - Fax:860-243-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4074258Medicaid
C00678Medicare ID - Type Unspecified