Organization
SPECIALISTS IN WOMEN'S HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CONRAD KACZMAREK MD (MD PRESIDENT)
(203) 754-2535
Entity
Organization
Contact information
Practice address
134 GRANDVIEW AVE, STE 210, WATERBURY, CT 06708-2507
(203) 754-2535
(203) 754-0788
Mailing address
134 GRANDVIEW AVE, STE 210, WATERBURY, CT 06708-2507
(203) 754-2535
(203) 754-0788
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004190310
—
CT
Enumeration date
08/03/2005
Last updated
04/18/2013
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