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General NPI Number Information
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NPI Number | 1346059565
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Entity Type | Individual
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Provider Name | PETER ANTHONY WASIUK AU.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 40 STANFORD DR
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City | FARMINGTON
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State | CT
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Zip | 06032-2454
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Country | US
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Telephone | 860-640-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 438 WHITNEY AVE APT 9
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City | NEW HAVEN
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State | CT
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Zip | 06511-2349
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Country | US
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Telephone | 603-944-2874
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000732
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License Number State | CT
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