Provider Demographics
NPI:1730408535
Name:SZUTOWSKA, MAGDALENA (DO)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:SZUTOWSKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHAWS CV
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4956
Mailing Address - Country:US
Mailing Address - Phone:860-447-2377
Mailing Address - Fax:860-447-2935
Practice Address - Street 1:4 SHAWS CV
Practice Address - Street 2:SUITE 204
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4956
Practice Address - Country:US
Practice Address - Phone:860-447-2377
Practice Address - Fax:860-447-2935
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT053390207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT053390OtherLICENSE