Individual
CYNTHIA DAY BACZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001540
CT
363AM0700X
Medical Physician Assistant
001540
CT
363AS0400X
Surgical Physician Assistant
Primary
001540
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050540
CTCARE PROVIDER ID
CT
Enumeration date
06/22/2005
Last updated
03/14/2017
Update your record
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