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1568412989

NPI Code Detail

MEDICARE: DONNA W KLIMOWICZ M.D.

MEDICARE: DONNA W KLIMOWICZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	041204	CT
2	2084P0802X	Addiction Psychiatry Physician	041204	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	106276	OTHER	CT	MANAGED HEALTH NETWORK
3	ANC1406	OTHER	CT	OXFORD BEHAVIORAL HEALTH
4	041204	OTHER	CT	PHYSICIAN/SURGEON
5	235143	OTHER	CT	COMPSYCH
6	77ABH0005CT01	OTHER	CT	ANTHEM BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1568412989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA W KLIMOWICZ M.D.

Provider Business Mailing Address
First Line	:	949 BRIDGEPORT AVE
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-3142
Country	:	US
Telephone Number	:	203-878-6365
Fax Number	:

Provider Business Practice Location Address
First Line	:	949 BRIDGEPORT AVE
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-3142
Country	:	US
Telephone Number	:	203-878-6365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	09/02/2011

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Directions to “ DONNA W KLIMOWICZ M.D.” Practice Location

Language	Start Address	Practice Location

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