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NPI Code Detail

MEDICARE: WIOLETTA HRYSZAN PMHNP-BC

MEDICARE: WIOLETTA HRYSZAN PMHNP-BC
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
1101YM0800XMental Health Counselor
2363LP0808XPsychiatric/Mental Health Nurse Practitioner12.008235CT

General Provider Information

NPI Number : 1720305113
Entity Type Code : Individual
Provider Name (Legal Business Name) : WIOLETTA HRYSZAN PMHNP-BC
Provider Business Mailing Address
First Line : 140 N FRONTAGE RD
Second Line :
City : MANSFIELD CENTER
State : CT
Zip : 06250-1648
Country : US
Telephone Number : 860-456-2261
Fax Number :
Provider Business Practice Location Address
First Line : 140 N FRONTAGE RD
Second Line :
City : MANSFIELD CENTER
State : CT
Zip : 06250-1648
Country : US
Telephone Number : 860-456-2261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2010
Last Update Date : 02/28/2020

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