Individual
TETIANA KIHICZAK BAZARKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
389 HIGHLAND AVE, WATERBURY, CT 06708-3444
(203) 754-0879
(203) 757-4123
Mailing address
389 HIGHLAND AVE, WATERBURY, CT 06708-3444
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000914
CT
213E00000X
Podiatrist
25MD00271900
NJ
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
000914
CT
213EP1101X
Primary Podiatric Medicine Podiatrist
25MD00271900
NJ
213ES0131X
Foot Surgery Podiatrist
25MD00271900
NJ
Other
Enumeration date
12/18/2006
Last updated
08/06/2019
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