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General NPI Number Information
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NPI Number | 1649713926
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Entity Type | Individual
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Provider Name | KAROLINA ZOFIA DUDZIK APRN
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Gender | Female
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 687 CAMPBELL AVE
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City | WEST HAVEN
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State | CT
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Zip | 06516-3774
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Country | US
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Telephone | 203-932-6481
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Fax | 203-932-4051
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Provider Business Mailing Address
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Address Line | 34 PARK ST
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City | NEW HAVEN
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State | CT
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Zip | 06519-1109
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Country | US
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Telephone | 203-974-7313
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12.006838
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 6838
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License Number State | CT
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