1386630291 NPI number — DR. NATALIE SAVICH KOMAISZKO MD

Table of content: DR. NATALIE SAVICH KOMAISZKO MD (NPI 1386630291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386630291 NPI number — DR. NATALIE SAVICH KOMAISZKO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOMAISZKO
Provider First Name:
NATALIE
Provider Middle Name:
SAVICH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAVICH
Provider Other First Name:
NATALIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386630291
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1080 DAY HILL RD
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
WINDSOR
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06095-1781
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-285-8017
Provider Business Mailing Address Fax Number:
860-688-5729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1080 DAY HILL RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
WINDSOR
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06095-1781
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-285-8017
Provider Business Practice Location Address Fax Number:
860-688-5729
Provider Enumeration Date:
09/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  047812 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010080331MA01 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 347460 . This is a "HEALTHSOURCE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000008142 . This is a "BOSTON MED CENTER HEALTHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201048 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 975890 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 16213 . This is a "HEALTH NEW ENGLAND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3145115 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 347460 . This is a "HEALTHSOURCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 521349 . This is a "AETNA USHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080331 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 707722 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 101298 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 33004 . This is a "CHILDRENS MEDICAL SECURIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: J16283 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1240477 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".




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