Provider Demographics
NPI:1023845567
Name:LASZKIEWICZ, MALGORZATA
Entity type:Individual
Prefix:MRS
First Name:MALGORZATA
Middle Name:
Last Name:LASZKIEWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WOOSTER ST UNIT 3B
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-3145
Mailing Address - Country:US
Mailing Address - Phone:203-598-1062
Mailing Address - Fax:
Practice Address - Street 1:80 HERITAGE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1882
Practice Address - Country:US
Practice Address - Phone:203-936-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2391225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant