Individual
BEVERLY WACZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
64 ROBBINS ST, WATERBURY, CT 06708-2613
(203) 573-6295
(203) 573-7613
Mailing address
64 ROBBINS ST, WATERBURY, CT 06721-1589
(203) 573-6295
(203) 573-7613
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001477
CT
Other
Enumeration date
07/15/2006
Last updated
01/08/2008
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