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General NPI Number Information
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NPI Number | 1407690704
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Entity Type | Individual
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Provider Name | WIKTORIA ANNA GALICA PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 30 W AVON RD STE E
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City | AVON
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State | CT
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Zip | 06001-3678
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Country | US
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Telephone | 860-674-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 300 BRITTANY FARMS RD APT D
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City | NEW BRITAIN
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State | CT
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Zip | 06053-1176
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Country | US
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Telephone | 215-499-9230
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6637
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License Number State | CT
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