Provider Demographics
NPI:1962504779
Name:GASIOROWSKI, HENRY C (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:C
Last Name:GASIOROWSKI
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 1:40 WEST ELM STREET
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830
Mailing Address - Country:US
Mailing Address - Phone:203-661-7546
Mailing Address - Fax:203-661-0085
Practice Address - Street 1:40 WEST ELM STREET
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830
Practice Address - Country:US
Practice Address - Phone:203-661-7546
Practice Address - Fax:203-661-0085
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT24975207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology