Healthcare Provider Details

I. General information

NPI: 1063378487
Provider Name (Legal Business Name): DOROTA GORCZYNSKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 PARK AVE
FAIRFIELD CT
06825-1090
US

IV. Provider business mailing address

43 BROOK LN
NORTH BRANFORD CT
06471-1121
US

V. Phone/Fax

Practice location:
  • Phone: 203-371-7999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number157617
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: