MEDICARE: MS. DEBORAH A KORNITSKY PAUSIG

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1861707820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH A KORNITSKY PAUSIG

Provider Business Mailing Address
First Line	:	5 ROGER AVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-1928
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 ROGER AVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-1928
Country	:	US
Telephone Number	:	203-239-3487
Fax Number	:

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

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	08/16/2010

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