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Individual

MARIELA PODOLSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
433 S MAIN ST STE 327, WEST HARTFORD, CT 06110-2816
(860) 410-4007
(860) 955-4804
Mailing address
44 FIELDSTONE DR, SOUTH GLASTONBURY, CT 06073-3718
(860) 707-4880
(860) 955-4804

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
050622
CT
2084P0800X
Psychiatry Physician
266869
MA
2084P0804X
Child & Adolescent Psychiatry Physician
050622
CT
2084P0804X
Child & Adolescent Psychiatry Physician
266869
MA
2084P0804X
Child & Adolescent Psychiatry Physician
8279
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004025177
CT
05
004041729
CT
Enumeration date
08/19/2007
Last updated
06/22/2023
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