Individual
MR. TIMOTHY G WAKSMONSKI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8408
(860) 444-8413
Mailing address
1538 ROUTE 12, UNIT 7, GALES FERRY, CT 06335-1845
(860) 444-8408
(860) 444-8413
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
24720000X
CA
Other
Enumeration date
03/20/2006
Last updated
07/08/2007
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