Individual
MRS. DOROTA PAWLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-2212
(860) 679-8758
(860) 679-1824
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
002949
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002949
2
CT
05
—
1710061858
—
CT
Enumeration date
10/25/2006
Last updated
11/07/2022
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