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Individual

JACLYN MARIE VITKOVSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
503 NEW HARWINTON RD, TORRINGTON, CT 06790-5845
(914) 552-2868
Mailing address
79 WOODSIDE CT, WATERTOWN, CT 06795-1152
(203) 232-5397

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
107346
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9168
CT

Other

Enumeration date
09/18/2020
Last updated
11/03/2020
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