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NPI 1104803808

NPI 1104803808 : WILLIAM PRESKENIS MD : GLASTONBURY, CT

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General NPI Number Information
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    NPI Number           |    1104803808
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM PRESKENIS MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/23/2005
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    Last Update Date     |    03/07/2023
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Provider Practice Location Address
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    Address Line         |    27 SYCAMORE ST STE 100, PRIME HEALTHCARE
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    City                 |    GLASTONBURY
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    State                |    CT
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    Zip                  |    06033-2223
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    Country              |    US
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    Telephone            |    860-659-0581
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    Fax                  |    860-652-3077
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Provider Business Mailing Address
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    Address Line         |    30 JORDAN LN PRIME HEALTHCARE
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    City                 |    WETHERSFIELD
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    State                |    CT
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    Zip                  |    06109-1278
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    Country              |    US
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    Telephone            |    860-263-0253
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    Fax                  |    860-263-0262
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RP1001X
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    Taxonomy Name        |    Pulmonary Disease Physician
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    License Number       |    026608
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    License Number State |    CT
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