Healthcare Provider Details

I. General information

NPI: 1649105735
Provider Name (Legal Business Name): RYAN JAMES ORLOWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 BLOOMFIELD AVE STE 301
WINDSOR CT
06095-2700
US

IV. Provider business mailing address

110 JOBS HILL RD APT 100
ELLINGTON CT
06029-3348
US

V. Phone/Fax

Practice location:
  • Phone: 860-831-4126
  • Fax:
Mailing address:
  • Phone: 860-944-4846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: