Individual
TATIANA ZINCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(203) 576-6000
Mailing address
46 HOP BROOK RD, BROOKFIELD, CT 06804-1326
(203) 775-3810
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036575
CT
208000000X
Pediatrics Physician
210743
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10450881
CAQH
—
Enumeration date
09/20/2005
Last updated
02/29/2016
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