MEDICARE: DR. MICHAEL M KRINSKY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	18133	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	714856	OTHER	CONNECTICARE
2	0P0200	OTHER	HEALTHNET
3	010018133CT01	OTHER	BCBS ANTHEM

General Provider Information

NPI Number	:	1508898339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL M KRINSKY MD

Provider Business Mailing Address
First Line	:	580 COTTAGE GROVE RD
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3088
Country	:	US
Telephone Number	:	860-243-9709
Fax Number	:	860-243-2522

Provider Business Practice Location Address
First Line	:	580 COTTAGE GROVE RD
Second Line	:
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3088
Country	:	US
Telephone Number	:	860-243-9709
Fax Number	:	860-243-2522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/08/2007

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