Provider Demographics
NPI:1487768305
Name:DOMBROWSKI, CHRISTINE D (CNM)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:D
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 STEVENS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06856
Mailing Address - Country:US
Mailing Address - Phone:203-644-1100
Mailing Address - Fax:203-644-1111
Practice Address - Street 1:30 STEVENS ST
Practice Address - Street 2:SUITE B
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06856
Practice Address - Country:US
Practice Address - Phone:203-644-1100
Practice Address - Fax:203-644-1111
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000059367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NPP000Medicare UPIN
CT42000050Medicare ID - Type Unspecified