Individual
MRS. TAMARA KALISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A..
Contact information
Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-1580
(203) 732-1576
Mailing address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-1580
(203) 732-1576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA000625
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062500
CONNECTICARE
CT
01
—
290000625CT01
BLUE CROSS BLUE SHIELD
CT
01
—
2V1674
HEALTHNET
CT
01
—
A752119
OXFORD
CT
Enumeration date
06/07/2006
Last updated
07/09/2007
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