Healthcare Provider Details

I. General information

NPI: 1609293570
Provider Name (Legal Business Name): PATRICIA SLIWINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 07/21/2022
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 E MAIN ST
BRIDGEPORT CT
06608-1913
US

IV. Provider business mailing address

982 E MAIN ST
BRIDGEPORT CT
06608-1913
US

V. Phone/Fax

Practice location:
  • Phone: 203-696-3260
  • Fax: 203-696-3269
Mailing address:
  • Phone: 203-696-3260
  • Fax: 203-696-3269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number289003
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number64821
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: