Healthcare Provider Details

I. General information

NPI: 1760579296
Provider Name (Legal Business Name): TERESA M SZAJDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 NORTH WASHINGTON STREET SUITE 109
PLAINVILLE CT
06062-8026
US

IV. Provider business mailing address

PO BOX 8026 7 NORTH WASHINGTON STREET SUITE 109
PLAINVILLE CT
06062-8026
US

V. Phone/Fax

Practice location:
  • Phone: 860-747-8118
  • Fax: 860-747-1633
Mailing address:
  • Phone: 860-747-8118
  • Fax: 860-747-1633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number029393
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0R1832
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerHEALTHNET
# 2
Identifier010029393CT01
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerANTHEM BCBS
# 3
Identifier773713
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerCONNECTICARE
# 4
Identifier45758
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerAETNA US HEALTHCARE
# 5
IdentifierHAP050
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerOXFORD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: