Healthcare Provider Details

I. General information

NPI: 1730522897
Provider Name (Legal Business Name): KATERINA DUKLESKA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 FARMINGTON AVE
FARMINGTON CT
06030-8072
US

IV. Provider business mailing address

263 FARMINGTON AVE
FARMINGTON CT
06030-8072
US

V. Phone/Fax

Practice location:
  • Phone: 860-679-4410
  • Fax:
Mailing address:
  • Phone: 860-679-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number62799
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT204362
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number68696
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number68696
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: