Healthcare Provider Details

I. General information

NPI: 1154503407
Provider Name (Legal Business Name): JENNIFER MARGARET TRZASKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER M TRZASKI MALASH M.D.

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST CCMC DIVISION OF NEONATOLOGY
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST CCMC DIVISION OF NEONATOLOGY
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-8950
  • Fax: 860-545-8945
Mailing address:
  • Phone: 860-545-8950
  • Fax: 860-545-8945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number046466
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: