Individual
JOHN ALEXANDER MICHALAK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 444-5151
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(857) 275-8313
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12294
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12294
INTERVENTIONAL RADIOLOGY
CT
Enumeration date
01/12/2022
Last updated
09/08/2023
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