Healthcare Provider Details

I. General information

NPI: 1821969221
Provider Name (Legal Business Name): MAYA WANLA WROBLEWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 FARMINGTON AVE
WEST HARTFORD CT
06107-2618
US

IV. Provider business mailing address

519 WORTHINGTON RDG
BERLIN CT
06037-2332
US

V. Phone/Fax

Practice location:
  • Phone: 860-521-9877
  • Fax:
Mailing address:
  • Phone: 860-538-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0017140
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: