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General NPI Number Information
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NPI Number | 1346477114
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Entity Type | Individual
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Provider Name | TOMASZ ADAM WIRASZKA MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 87 GRANDVIEW AVE
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City | WATERBURY
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State | CT
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Zip | 06708-2514
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Country | US
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Telephone | 203-693-4973
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Fax |
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Provider Business Mailing Address
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Address Line | 87 GRANDVIEW AVE
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City | WATERBURY
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State | CT
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Zip | 06708-2514
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Country | US
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Telephone | 203-693-4973
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | P0519
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD465347
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 82005
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License Number State | CT
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