MEDICARE: MARIA L WESELYJ PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	5440	CT
2	363A00000X	Physician Assistant	5440	CT

General Provider Information

NPI Number	:	1417549379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA L WESELYJ PA-C

Provider Business Mailing Address
First Line	:	85 SEYMOUR ST STE 1003
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-5529
Country	:	US
Telephone Number	:	860-972-2780
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 SEYMOUR ST STE 1003
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-5529
Country	:	US
Telephone Number	:	860-972-2780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	04/03/2026

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Directions to “ MARIA L WESELYJ PA-C” Practice Location

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