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NPI Code Detail

MEDICARE: PAMELA ZMIJEWSKI RDH

MEDICARE:   PAMELA  ZMIJEWSKI  RDH
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
1124Q00000XDental Hygienist004557CT

General Provider Information

NPI Number : 1982692018
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA ZMIJEWSKI RDH
Provider Business Mailing Address
First Line : 635 MAIN ST
Second Line : ATTN: CREDENTIALING DEPARTMENT
City : MIDDLETOWN
State : CT
Zip : 06457-2718
Country : US
Telephone Number : 860-347-6971
Fax Number : 860-638-6601
Provider Business Practice Location Address
First Line : 1 SHAWS CV
Second Line :
City : NEW LONDON
State : CT
Zip : 06320-4902
Country : US
Telephone Number : 860-447-8304
Fax Number : 860-443-8720
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 07/08/2007

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Directions to “ PAMELA ZMIJEWSKI RDH” Practice Location

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