Individual
MR. JOHN D WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 TAMARACK AVE, SUITE 101, SOUTH WINDSOR, CT 06074-5555
(860) 644-4442
(860) 644-1412
Mailing address
10 JOLLEY DR, STE 102, BLOOMFIELD, CT 06002-3061
(860) 257-4131
(860) 257-4519
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
055947
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4886159
AETNA
CT
01
—
7019762
CIGNA
CT
Enumeration date
04/10/2009
Last updated
07/21/2022
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