Provider Demographics
NPI:1750401675
Name:BORIS J. SAWULA, M.D., P.C.
Entity type:Organization
Organization Name:BORIS J. SAWULA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAWULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-489-1038
Mailing Address - Street 1:538 LITCHFIELD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6669
Mailing Address - Country:US
Mailing Address - Phone:860-489-1038
Mailing Address - Fax:860-496-4094
Practice Address - Street 1:538 LITCHFIELD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6669
Practice Address - Country:US
Practice Address - Phone:860-489-1038
Practice Address - Fax:860-496-4094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT24654207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty