Doctor Name: | MR. MICHAEL ALEXANDER SYWAK |
NPI Number: | 1003104639 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 64 Robbins St Waterbury, CT - 067082613 |
Business Phone Number: | 2035737257 |
Business Fax Number: | 2035736073 |
Mailing Address: | 56 Zuella Dr Apt 1b, WATERBURY |
State: | CT |
Postal Code: | 067041942 |
Phone Number: | 7166988704 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2011 |
NPI Last Update Date: | 07/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |