Healthcare Provider Details

I. General information

NPI: 1205449337
Provider Name (Legal Business Name): KAMILA ZLOTOSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAMILA AGNIESZKA ZLOBICKA

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FERRY ST STE 313
CONCORD NH
03301-5004
US

IV. Provider business mailing address

PO BOX 1595
MIDDLETOWN CT
06457-8095
US

V. Phone/Fax

Practice location:
  • Phone: 860-788-6404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number072225-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP241335
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: