Basic Information
| Provider Information | |||||||||
| NPI: | 1073870697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEORGE | ||||||||
| FirstName: | GENY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1290 SILAS DEANE HWY | ||||||||
| Address2: | |||||||||
| City: | WETHERSFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061094337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609729093 | ||||||||
| FaxNumber: | 8609727040 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 TECHNOLOGY DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | TRUMBULL | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066116337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033727200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2012 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 283653 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RE0101X | 25MA10398200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 207RE0101X | 71693 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.