Healthcare Provider Details

I. General information

NPI: 1861998171
Provider Name (Legal Business Name): PAULINA PIEKARSKA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 MAIN AVE STE 116
NORWALK CT
06851-1080
US

IV. Provider business mailing address

761 MAIN AVE STE 115
NORWALK CT
06851-1080
US

V. Phone/Fax

Practice location:
  • Phone: 203-845-2200
  • Fax:
Mailing address:
  • Phone: 203-845-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1120
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number10485
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: