Individual
REBECCA LYNN LADYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
320 POMFRET ST, PUTNAM, CT 06260-1836
(860) 382-5474
Mailing address
PO BOX 263, NORTH GROSVENORDALE, CT 06255-0263
(860) 382-5474
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2488
CT
363AM0700X
Medical Physician Assistant
Primary
002488
CT
Other
Enumeration date
11/02/2010
Last updated
06/25/2015
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