Doctor Name: | MRS. LINDA S KOWALCZUK |
NPI Number: | 1124171103 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 001329 |
Business Practice Address: | 720 Hopmeadow St Simsbury, CT - 060702224 |
Business Phone Number: | 8606513519 |
Business Fax Number: | 8606514133 |
Mailing Address: | 40 Hyde St, TORRINGTON |
State: | CT |
Postal Code: | 067906006 |
Phone Number: | 8604960790 |
Fax Number: | |
NPI Enumeration Date: | 01/21/2007 |
NPI Last Update Date: | 02/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 001329 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |