Healthcare Provider Details

I. General information

NPI: 1326593450
Provider Name (Legal Business Name): MALGORZATA RODZYN-SALOMONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MALGORZATA RODZYN

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 BOSTON AVE
STRATFORD CT
06614-5246
US

IV. Provider business mailing address

1558 BARNUM AVE
BRIDGEPORT CT
06610-3238
US

V. Phone/Fax

Practice location:
  • Phone: 203-384-3377
  • Fax:
Mailing address:
  • Phone: 203-384-3377
  • Fax: 203-378-8578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number009406
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: