Individual
EPHRAIM WAKSZUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
19 WOODLAND ST STE 23, HARTFORD, CT 06105-2368
(860) 522-2251
Mailing address
19 WOODLAND ST STE 23, HARTFORD, CT 06105-2368
(860) 522-2251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
23 017623
NY
363A00000X
Physician Assistant
25MP00336900
NJ
363A00000X
Physician Assistant
Primary
3330
CT
363AM0700X
Medical Physician Assistant
3330
CT
Other
Enumeration date
06/06/2014
Last updated
02/23/2021
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