Healthcare Provider Details

I. General information

NPI: 1952373136
Provider Name (Legal Business Name): LESLIE S SWIDERSKI RN,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 ROBBINS ST
WATERBURY CT
06708-2613
US

IV. Provider business mailing address

66 COLONIAL RD
WATERTOWN CT
06795-3106
US

V. Phone/Fax

Practice location:
  • Phone: 203-573-6500
  • Fax: 203-573-7007
Mailing address:
  • Phone: 860-274-1418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number005715
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberE36457
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: