Geronimo, Mark Dennis V
Geronimo, Mark Dennis V is an individual health care provider with primary practice located at 365 Montauk Ave , New London CT 06320-4700. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Geronimo, Mark Dennis V can be contacted via phone (860) 442-0711.Contact Information
Primary practice address
365 Montauk Ave
New London CT 06320-4700
Phone: (860) 442-0711
Fax: (413) 543-7962
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2010024512 | Missouri |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036128606 | Illinois |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 52895 | Connecticut |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 52895 | Connecticut |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036128606 | Illinois |
Profile Details
| NPI number | 1215132949 |
|---|---|
| LBN Legal business name | Geronimo, Mark Dennis V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2007 |
| Last updated | Jul 22nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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