Healthcare Provider Details
I. General information
NPI: 1548203359
Provider Name (Legal Business Name): KRYSTYNA SIKORSKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/13/2006
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
299 CAREW ST NEW ENGLAND PATNOLOGY ASSOCIATES PC
SPRINGFIELD MA
01104
US
IV. Provider business mailing address
PO BOX 789
LUDLOW MA
01056-0789
US
V. Phone/Fax
- Phone: 413-748-9513
- Fax: 413-748-6844
- Phone: 413-509-1000
- Fax: 413-509-1003
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZB0001X |
| Taxonomy | Blood Banking & Transfusion Medicine Physician |
| License Number | 156144 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: