Provider Demographics
NPI:1215287214
Name:CONOSCENTI, CRAIG STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STEPHEN
Last Name:CONOSCENTI
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 1:199 GREGORY BLVD
Mailing Address - Street 2:UNIT I5
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06855-2640
Mailing Address - Country:US
Mailing Address - Phone:203-482-3219
Mailing Address - Fax:
Practice Address - Street 1:199 GREGORY BLVD
Practice Address - Street 2:UNIT I5
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06855-2640
Practice Address - Country:US
Practice Address - Phone:203-482-3219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026787207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease