| Doctor Name: | MRS. ANDREA MARIE NIZIOLEK |
| NPI Number: | 1669415576 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 001752 |
| Business Practice Address: | 46 Ashley Park Dr North Branford, CT - 064711066 |
| Business Phone Number: | 2034846778 |
| Business Fax Number: | 2038675460 |
| Mailing Address: | 46 Ashley Park Dr, NORTH BRANFORD |
| State: | CT |
| Postal Code: | 064711066 |
| Phone Number: | 2034846778 |
| Fax Number: | 2038675460 |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 10/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 001752 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |